Provider Demographics
NPI:1376680629
Name:POCKETTE, JO D (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JO
Middle Name:D
Last Name:POCKETTE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 JACQUELINE LN
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4672
Mailing Address - Country:US
Mailing Address - Phone:508-833-3800
Mailing Address - Fax:508-746-6865
Practice Address - Street 1:24 JACQUELINE LN
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4672
Practice Address - Country:US
Practice Address - Phone:508-833-3800
Practice Address - Fax:508-746-6865
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10247931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7623236OtherAETNA
MA112099000OtherMAGELLAN
MAP07156OtherBCBS