Provider Demographics
NPI:1083182125
Name:PARKER, JENNIFER LESLIE (LICSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LESLIE
Last Name:PARKER
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 1:10 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:NEW SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01355-5506
Mailing Address - Country:US
Mailing Address - Phone:413-687-2926
Mailing Address - Fax:
Practice Address - Street 1:10 HUNT RD
Practice Address - Street 2:
Practice Address - City:NEW SALEM
Practice Address - State:MA
Practice Address - Zip Code:01355-5506
Practice Address - Country:US
Practice Address - Phone:413-687-2926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106980104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker