Provider Demographics
NPI:1851695209
Name:HELWIG, JOHANNA ELIZABETH (LICSW)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:ELIZABETH
Last Name:HELWIG
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JOHANNA
Other - Middle Name:E
Other - Last Name:TOSCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:5 AVON ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1814
Mailing Address - Country:US
Mailing Address - Phone:508-423-2164
Mailing Address - Fax:
Practice Address - Street 1:5 AVON ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1814
Practice Address - Country:US
Practice Address - Phone:508-423-2164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA111366103TC0700X
MA113661041C0700X
1113661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical