Healthcare Provider Details

I. General information

NPI: 1962333476
Provider Name (Legal Business Name): JALEESA MARSHALL-JENG PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COUNTY CIR
AMHERST MA
01003-9255
US

IV. Provider business mailing address

45 SUTTON PL
BLOOMFIELD CT
06002-4002
US

V. Phone/Fax

Practice location:
  • Phone: 413-545-2337
  • Fax: 413-545-9602
Mailing address:
  • Phone: 347-977-7423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: