Provider Demographics
NPI:1639384423
Name:BIANCHI, JOAN ALEXANDER (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:ALEXANDER
Last Name:BIANCHI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:
Other - Last Name:ALEXANDER CSW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01070
Mailing Address - Country:US
Mailing Address - Phone:413-634-8849
Mailing Address - Fax:
Practice Address - Street 1:5 STATE STREET
Practice Address - Street 2:OFFICE #3
Practice Address - City:SHELBURNE FALLS
Practice Address - State:MA
Practice Address - Zip Code:01370
Practice Address - Country:US
Practice Address - Phone:413-634-8849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA112182101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical