Healthcare Provider Details

I. General information

NPI: 1003797267
Provider Name (Legal Business Name): JENNIFER LOUISE MARQUEZ MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 GROVE ST STE LL11
WORCESTER MA
01605-2677
US

IV. Provider business mailing address

21 SALISBURY ST APT 7
WORCESTER MA
01609-3148
US

V. Phone/Fax

Practice location:
  • Phone: 508-304-7499
  • Fax: 774-420-7255
Mailing address:
  • Phone: 774-312-4749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: