Provider Demographics
NPI:1649056177
Name:BOSSERT, JANIS L (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:L
Last Name:BOSSERT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 W CRYSTAL LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-3200
Mailing Address - Country:US
Mailing Address - Phone:267-259-5370
Mailing Address - Fax:
Practice Address - Street 1:259 W CRYSTAL LAKE AVE
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-3200
Practice Address - Country:US
Practice Address - Phone:267-259-5370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0204701041C0700X
NJ44SC058179001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical