Healthcare Provider Details

I. General information

NPI: 1376894485
Provider Name (Legal Business Name): JENNIFER KINSEY MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2012
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MIRONA ROAD EXT STE 3
PORTSMOUTH NH
03801-5385
US

IV. Provider business mailing address

PO BOX 688
STRATHAM NH
03885-0688
US

V. Phone/Fax

Practice location:
  • Phone: 603-770-0567
  • Fax: 603-766-3141
Mailing address:
  • Phone: 603-770-0567
  • Fax: 603-766-3141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1674
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: