Provider Demographics
NPI:1255622288
Name:JEWELL, JANICE C (LICSW)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:C
Last Name:JEWELL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210B WALTON RD
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4521
Mailing Address - Country:US
Mailing Address - Phone:978-314-9781
Mailing Address - Fax:
Practice Address - Street 1:1 LIBERTY LN E STE 204
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-1839
Practice Address - Country:US
Practice Address - Phone:603-814-1484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NH2029104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker