Provider Demographics
NPI:1831176932
Name:HOWARD, MICHELE (LICSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:HOWARD
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 1:64 WESTBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-3327
Mailing Address - Country:US
Mailing Address - Phone:617-332-1990
Mailing Address - Fax:
Practice Address - Street 1:64 WESTBOURNE ST
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-3327
Practice Address - Country:US
Practice Address - Phone:617-947-3040
Practice Address - Fax:617-323-1940
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10162981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical