Provider Demographics
NPI:1538197199
Name:BOSKIND, JO ELLEN (MSW)
Entity type:Individual
Prefix:MS
First Name:JO ELLEN
Middle Name:
Last Name:BOSKIND
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 MECHANIC ST
Mailing Address - Street 2:MEDICAL ARTS BUILDING
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-3534
Mailing Address - Country:US
Mailing Address - Phone:978-249-0929
Mailing Address - Fax:978-249-5323
Practice Address - Street 1:80 MECHANIC ST
Practice Address - Street 2:MEDICAL ARTS BUILDING
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-3534
Practice Address - Country:US
Practice Address - Phone:978-249-0929
Practice Address - Fax:978-249-5323
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1016491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA764004OtherTUFTS HMO
MA1004555OtherBEACON HEALTH STRATEGIES
MAP01523OtherBLUE CROSS BLUE SHIELD
MA764004OtherTUFTS HMO