Provider Demographics
NPI:1568452480
Name:WINN, JOSEPH ROBERT (MSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ROBERT
Last Name:WINN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15 WALTHAM ST
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754-2411
Mailing Address - Country:US
Mailing Address - Phone:978-897-4242
Mailing Address - Fax:978-897-4713
Practice Address - Street 1:226 MASSACHUSETTS AVE
Practice Address - Street 2:SUITE NUMBER 3
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8435
Practice Address - Country:US
Practice Address - Phone:617-461-8479
Practice Address - Fax:978-897-4713
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10286901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1852957Medicaid
MA7052259OtherAETNA
MAP08030OtherBLUE CROSS BLUE SHIELD MA
MAP08030OtherPERSONAL HELP CONNECTION
MA7052259OtherAETNA