Provider Demographics
NPI:1083462998
Name:OELSCHEGEL, JENNA KATHLEEN (LCSW)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:KATHLEEN
Last Name:OELSCHEGEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 MAIN ST.
Mailing Address - Street 2:STE 100
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452
Mailing Address - Country:US
Mailing Address - Phone:781-268-8871
Mailing Address - Fax:
Practice Address - Street 1:3600 RED RD STE 601A
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-6016
Practice Address - Country:US
Practice Address - Phone:781-268-8871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2260771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical