MEDICARE: JO ANNE SOSHNICK MSW

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
1	1041C0700X	Clinical Social Worker	117306	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	117306	OTHER	MA	BOARD OF REGISTRATION OF SOCIAL WORKERS

General Provider Information

NPI Number	:	1013517549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JO ANNE SOSHNICK MSW

Provider Business Mailing Address
First Line	:	PO BOX 2
Second Line	:
City	:	SHARON
State	:	MA
Zip	:	02067-0002
Country	:	US
Telephone Number	:	339-364-8080
Fax Number	:	781-436-5829

Provider Business Practice Location Address
First Line	:	378 PAGE ST STE 6
Second Line	:
City	:	STOUGHTON
State	:	MA
Zip	:	02072-1124
Country	:	US
Telephone Number	:	339-364-8080
Fax Number	:	781-436-5829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2020
Last Update Date	:	10/26/2020

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