Provider Demographics
NPI:1154431468
Name:HOWARD, JANICE ELAINE (LICSW)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:ELAINE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:HANSON
Mailing Address - State:MA
Mailing Address - Zip Code:02341-1110
Mailing Address - Country:US
Mailing Address - Phone:781-826-5333
Mailing Address - Fax:
Practice Address - Street 1:2 COLUMBIA RD STE 8
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1842
Practice Address - Country:US
Practice Address - Phone:781-826-5333
Practice Address - Fax:781-826-6807
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10245781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851748Medicaid
MA1851748Medicaid