Provider Demographics
NPI:1962206714
Name:JAGENTENFL, MONICA (MSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:JAGENTENFL
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MELENDY HOLW
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2654
Mailing Address - Country:US
Mailing Address - Phone:603-801-7344
Mailing Address - Fax:
Practice Address - Street 1:12 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2950
Practice Address - Country:US
Practice Address - Phone:603-309-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical