Provider Demographics
NPI:1205088739
Name:ESPINOSA, JUANA IV (COUNSELOR / MSW)
Entity type:Individual
Prefix:MRS
First Name:JUANA
Middle Name:
Last Name:ESPINOSA
Suffix:IV
Gender:F
Credentials:COUNSELOR / MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 HOWARD ST.
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841
Mailing Address - Country:US
Mailing Address - Phone:978-655-5049
Mailing Address - Fax:
Practice Address - Street 1:11 LAWRENCE ST
Practice Address - Street 2:SUITE 322
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1431
Practice Address - Country:US
Practice Address - Phone:978-687-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health