Healthcare Provider Details

I. General information

NPI: 1093167652
Provider Name (Legal Business Name): JENNIFER LEHTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W MAIN ST STE 112
NORTHBOROUGH MA
01532-2132
US

IV. Provider business mailing address

300 W MAIN ST STE 112
NORTHBOROUGH MA
01532-2132
US

V. Phone/Fax

Practice location:
  • Phone: 774-345-9737
  • Fax: 844-550-1680
Mailing address:
  • Phone: 774-345-9737
  • Fax: 844-550-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2357361
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: