Provider Demographics
NPI:1386102275
Name:MASSIP, JENNIFER (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MASSIP
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:NMRTC NEW ENGLAND
Mailing Address - Street 2:43 SMITH ROAD
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02841
Mailing Address - Country:US
Mailing Address - Phone:401-841-3846
Mailing Address - Fax:
Practice Address - Street 1:NMRTC NEW ENGLAND
Practice Address - Street 2:43 SMITH ROAD
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02841
Practice Address - Country:US
Practice Address - Phone:401-841-3846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-09
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW152901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical