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NPI Code Detail

MEDICARE: JENNIFER KAPP MSW, LICSW

MEDICARE: JENNIFER KAPP MSW, LICSW
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
11041C0700XClinical Social Worker113304MA

General Provider Information

NPI Number : 1295225688
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER KAPP MSW, LICSW
Provider Business Mailing Address
First Line : 61 INDUSTRIAL PARK RD
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-7246
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 61 INDUSTRIAL PARK RD
Second Line :
City : PLYMOUTH
State : MA
Zip : 02360-7246
Country : US
Telephone Number : 508-732-6252
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2018
Last Update Date : 05/11/2018

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