Provider Demographics
NPI:1477725059
Name:FROST, JOANNA VICTORIA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:VICTORIA
Last Name:FROST
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 4541
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01014-4541
Mailing Address - Country:US
Mailing Address - Phone:413-534-3033
Mailing Address - Fax:413-534-3066
Practice Address - Street 1:700 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5309
Practice Address - Country:US
Practice Address - Phone:413-534-3033
Practice Address - Fax:413-534-3066
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1143301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical