Provider Demographics
NPI:1538218565
Name:BOWERS, JANET MARION (LICSW)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARION
Last Name:BOWERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:
Other - Last Name:BOWERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:19 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GILL
Mailing Address - State:MA
Mailing Address - Zip Code:01354-9723
Mailing Address - Country:US
Mailing Address - Phone:413-863-8795
Mailing Address - Fax:413-774-3599
Practice Address - Street 1:28 HIGH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2973
Practice Address - Country:US
Practice Address - Phone:413-774-3591
Practice Address - Fax:413-774-3599
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1028763101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP07723OtherBLUE CROSS BLUE SHIELD
MA7407443OtherAETNA
MA1890778Medicaid
MA1857592OtherQUALIFIED MEDICARE BENEFI
MAP20591Medicare ID - Type Unspecified