Provider Demographics
NPI:1124341839
Name:SHOEN, JENNA HELENE (MSW)
Entity type:Individual
Prefix:MS
First Name:JENNA
Middle Name:HELENE
Last Name:SHOEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:HELENE
Other - Last Name:RUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1233 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040
Mailing Address - Country:US
Mailing Address - Phone:413-539-2480
Mailing Address - Fax:413-539-2496
Practice Address - Street 1:1233 MAIN STREET
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040
Practice Address - Country:US
Practice Address - Phone:413-539-2480
Practice Address - Fax:413-539-2496
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health