Healthcare Provider Details

I. General information

NPI: 1275672214
Provider Name (Legal Business Name): RENATA LEPECKI JENCO M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RENATA LEPECKI

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 INTERSTATE DR
WEST SPRINGFIELD MA
01089-5100
US

IV. Provider business mailing address

5 NEWELL ST
CHICOPEE MA
01013-3820
US

V. Phone/Fax

Practice location:
  • Phone: 413-887-8385
  • Fax: 774-628-9657
Mailing address:
  • Phone: 413-552-0182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4759
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: