Provider Demographics
NPI:1376717488
Name:HUNTINGTON, JOANNA (LICSW)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:HUNTINGTON
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 1:5 AUTUMN ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1524
Mailing Address - Country:US
Mailing Address - Phone:781-727-3176
Mailing Address - Fax:978-861-4452
Practice Address - Street 1:10 LIBERTY ST
Practice Address - Street 2:SUITE 211
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2577
Practice Address - Country:US
Practice Address - Phone:781-727-3176
Practice Address - Fax:978-682-9333
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2147521041C0700X
MA1156891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical