Healthcare Provider Details

I. General information

NPI: 1922437193
Provider Name (Legal Business Name): ROUDNA ESTHER JOSEPH LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 HEATH ST
JAMAICA PLAIN MA
02130-1650
US

IV. Provider business mailing address

31 HEATH ST
JAMAICA PLAIN MA
02130-1650
US

V. Phone/Fax

Practice location:
  • Phone: 617-523-6400
  • Fax: 617-523-3034
Mailing address:
  • Phone: 617-523-6400
  • Fax: 617-523-3034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1120663
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: