Provider Demographics
NPI:1578724829
Name:CHOQUETTE, JOHN (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CHOQUETTE
Suffix:
Gender:M
Credentials:MSW, 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 MORRILL PL
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3530
Mailing Address - Country:US
Mailing Address - Phone:603-475-2912
Mailing Address - Fax:
Practice Address - Street 1:24 MORRILL PL
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3530
Practice Address - Country:US
Practice Address - Phone:603-475-2912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1157111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6395146OtherLMSW