Provider Demographics
NPI:1265315451
Name:COWIN, JONATHAN T (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:T
Last Name:COWIN
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MORA ST APT 3
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-4681
Mailing Address - Country:US
Mailing Address - Phone:315-559-2704
Mailing Address - Fax:
Practice Address - Street 1:44 BEARFOOT RD STE 300
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1563
Practice Address - Country:US
Practice Address - Phone:508-242-9666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW2120679104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker