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NPI Code Detail

MEDICARE: MS. JO ELLEN BOSKIND M.S.W.

MEDICARE: MS. JO ELLEN BOSKIND M.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker101649MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1764004OTHERMATUFTS HMO
21004555OTHERMABEACON HEALTH STRATEGIES
3P01523OTHERMABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1538197199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JO ELLEN BOSKIND M.S.W.
Provider Business Mailing Address
First Line : 80 MECHANIC ST
Second Line : MEDICAL ARTS BUILDING
City : ATHOL
State : MA
Zip : 01331-3534
Country : US
Telephone Number : 978-249-0929
Fax Number : 978-249-5323
Provider Business Practice Location Address
First Line : 80 MECHANIC ST
Second Line : MEDICAL ARTS BUILDING
City : ATHOL
State : MA
Zip : 01331-3534
Country : US
Telephone Number : 978-249-0929
Fax Number : 978-249-5323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 07/08/2007

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