MEDICARE: JENNIFER DONELAN PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1215865316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER DONELAN PHD

Provider Business Mailing Address
First Line	:	57 BEDFORD ST STE 100
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4550
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 BEDFORD ST STE 100
Second Line	:
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4550
Country	:	US
Telephone Number	:	781-862-4110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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Directions to “ JENNIFER DONELAN PHD” Practice Location

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