MEDICARE: MICHELE HOWARD 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	1016298	MA

General Provider Information

NPI Number	:	1831176932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE HOWARD LICSW

Provider Business Mailing Address
First Line	:	64 WESTBOURNE ST
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-3327
Country	:	US
Telephone Number	:	617-332-1990
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 WESTBOURNE ST
Second Line	:
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-3327
Country	:	US
Telephone Number	:	617-947-3040
Fax Number	:	617-323-1940

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

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	08/30/2018

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Directions to “ MICHELE HOWARD LICSW” Practice Location

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