Provider Demographics
NPI:1851375844
Name:POWSNER, JUDITH D (LICSW, LADC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:D
Last Name:POWSNER
Suffix:
Gender:F
Credentials:LICSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ACTON RD
Mailing Address - Street 2:SUITE 25
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3498
Mailing Address - Country:US
Mailing Address - Phone:978-256-6579
Mailing Address - Fax:978-256-1943
Practice Address - Street 1:9 ACTON RD
Practice Address - Street 2:SUITE 25
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3498
Practice Address - Country:US
Practice Address - Phone:978-256-6579
Practice Address - Fax:978-256-1943
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10162841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA020418OtherVALUE OPTIONS
MA1851900Medicaid
MA969855OtherNETWORK HEALTH
MA0022320OtherNHP
MA460072OtherTUFTS
NH14Y001261MA01OtherBCBSNH
MA333114OtherMHN
MA043476807-07OtherPACIFICARE
MAP06624OtherBCBSMA
MA1851900Medicaid