MEDICARE: MS. AMBER DAWN JANES LICSW

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	117442	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346337680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AMBER DAWN JANES LICSW

Provider Business Mailing Address
First Line	:	77 MILL ST
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-4598
Country	:	US
Telephone Number	:	413-568-1421
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 MILL ST
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-4598
Country	:	US
Telephone Number	:	413-568-1421
Fax Number	:

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	12/04/2014

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