Healthcare Provider Details

I. General information

NPI: 1962206714
Provider Name (Legal Business Name): MONICA JAGENTENFL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 MAIN DUNSTABLE RD STE 203
NASHUA NH
03060-3641
US

IV. Provider business mailing address

1 MELENDY HOLW
AMHERST NH
03031-2654
US

V. Phone/Fax

Practice location:
  • Phone: 978-300-0855
  • Fax:
Mailing address:
  • Phone: 603-801-7344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5282
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: