Provider Demographics
NPI:1407624232
Name:FUOCO, JENNI-LYNN (LICSW)
Entity type:Individual
Prefix:
First Name:JENNI-LYNN
Middle Name:
Last Name:FUOCO
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:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:POULTNEY
Mailing Address - State:VT
Mailing Address - Zip Code:05764-0189
Mailing Address - Country:US
Mailing Address - Phone:802-345-7599
Mailing Address - Fax:
Practice Address - Street 1:472 GRANVILLE ST
Practice Address - Street 2:
Practice Address - City:POULTNEY
Practice Address - State:VT
Practice Address - Zip Code:05764-1109
Practice Address - Country:US
Practice Address - Phone:802-345-7599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker