Healthcare Provider Details

I. General information

NPI: 1568485340
Provider Name (Legal Business Name): JANET TREANOR LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 COTUIT RD
MARSTONS MILLS MA
02648-1834
US

IV. Provider business mailing address

16 GRIST MILL RD
HARWICH MA
02645-1422
US

V. Phone/Fax

Practice location:
  • Phone: 508-428-3698
  • Fax: 508-428-0005
Mailing address:
  • Phone: 508-428-3698
  • Fax: 508-428-0005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1029743
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN106120
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: