Healthcare Provider Details

I. General information

NPI: 1225646987
Provider Name (Legal Business Name): JENNIFER SALTMARSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER MENCONI

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SEAPORT DR APT 310
QUINCY MA
02171-1577
US

IV. Provider business mailing address

7 SEAPORT DR APT 310
QUINCY MA
02171-1577
US

V. Phone/Fax

Practice location:
  • Phone: 617-396-4581
  • Fax:
Mailing address:
  • Phone: 508-319-9532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW128398
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: