Provider Demographics
NPI:1447864319
Name:OBERHEU, JANA (LICSW)
Entity type:Individual
Prefix:MS
First Name:JANA
Middle Name:
Last Name:OBERHEU
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 1:25B AUBURN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-1721
Mailing Address - Country:US
Mailing Address - Phone:941-266-6157
Mailing Address - Fax:
Practice Address - Street 1:165 CAPTAINS ROW
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-4019
Practice Address - Country:US
Practice Address - Phone:617-887-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1224341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical