MEDICARE: JENNIFER BITTNER

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	101YM0800X	Mental Health Counselor	9141	MA

General Provider Information

NPI Number	:	1609341718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER BITTNER

Provider Business Mailing Address
First Line	:	362 WARD ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02459-1217
Country	:	US
Telephone Number	:	617-201-0563
Fax Number	:

Provider Business Practice Location Address
First Line	:	378 PAGE ST
Second Line	:
City	:	STOUGHTON
State	:	MA
Zip	:	02072-1124
Country	:	US
Telephone Number	:	781-436-0150
Fax Number	:

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

Provider Enumeration Date	:	10/05/2018
Last Update Date	:	10/05/2018

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Directions to “ JENNIFER BITTNER ” Practice Location

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