Healthcare Provider Details

I. General information

NPI: 1487393492
Provider Name (Legal Business Name): JANA HELEN CHAUDHURI PH.D., LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 RIVER ST STE 1
WALTHAM MA
02453-5483
US

IV. Provider business mailing address

431 RIVER ST STE 1
WALTHAM MA
02453-5483
US

V. Phone/Fax

Practice location:
  • Phone: 781-966-5650
  • Fax:
Mailing address:
  • Phone: 781-966-8536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW2140597
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: