Provider Demographics
NPI:1477651735
Name:YOWELL, CHARLENE L (LICSW)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:L
Last Name:YOWELL
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:PO BOX 482
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-0482
Mailing Address - Country:US
Mailing Address - Phone:508-285-5825
Mailing Address - Fax:508-285-2269
Practice Address - Street 1:8 LIBRARY SQ
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-2731
Practice Address - Country:US
Practice Address - Phone:508-285-5825
Practice Address - Fax:508-285-2269
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1032613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA356037OtherMAGELLAN BEH. HEALTH
MAP07656OtherBLUE CROSS BLUE SHIELD
MA356037OtherAETNA US HEALTHCARE
MA453562OtherTUFTS HEALTH PLAN
MAP22172Medicare ID - Type UnspecifiedMEDICARE