Provider Demographics
NPI:1306139423
Name:BELAND, JENNIFER M (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:BELAND
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CHELMSFORD ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-3309
Mailing Address - Country:US
Mailing Address - Phone:978-937-2846
Mailing Address - Fax:978-937-2855
Practice Address - Street 1:300 CHELMSFORD ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851
Practice Address - Country:US
Practice Address - Phone:978-937-2846
Practice Address - Fax:978-937-2855
Is Sole Proprietor?:No
Enumeration Date:2011-05-23
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1163311041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool