Provider Demographics
NPI:1013913649
Name:BYERS, JANIS J (MSW)
Entity Type:Individual
Prefix:MS
First Name:JANIS
Middle Name:J
Last Name:BYERS
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 1:116 ROUTE 6A
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02563-2062
Mailing Address - Country:US
Mailing Address - Phone:508-888-5157
Mailing Address - Fax:508-888-5005
Practice Address - Street 1:116 ROUTE 6A
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2062
Practice Address - Country:US
Practice Address - Phone:508-888-5157
Practice Address - Fax:508-888-5005
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1025956104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1891871Medicaid
MAP20178Medicare ID - Type UnspecifiedNATIONAL HERITAGE INSURAN