Healthcare Provider Details

I. General information

NPI: 1477994168
Provider Name (Legal Business Name): JENNA ST PIERRE LCAT, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 MARINE AVE APT A9
BROOKLYN NY
11209-8038
US

IV. Provider business mailing address

351 MARINE AVE APT A9
BROOKLYN NY
11209-8038
US

V. Phone/Fax

Practice location:
  • Phone: 413-519-8113
  • Fax: 347-466-6951
Mailing address:
  • Phone: 413-519-8113
  • Fax: 347-466-6951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number002182
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: