Provider Demographics
NPI:1013517549
Name:SOSHNICK, JO ANNE (MSW)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:ANNE
Last Name:SOSHNICK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-0002
Mailing Address - Country:US
Mailing Address - Phone:339-364-8080
Mailing Address - Fax:781-436-5829
Practice Address - Street 1:378 PAGE ST STE 6
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1124
Practice Address - Country:US
Practice Address - Phone:339-364-8080
Practice Address - Fax:781-436-5829
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1173061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA117306OtherBOARD OF REGISTRATION OF SOCIAL WORKERS