=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275496812
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDSEY NICOLE JENNINGS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2025
-----------------------------------------------------
Last Update Date | 12/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16 TOWN CRIER DR
-----------------------------------------------------
City | BRATTLEBORO
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05301-8669
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-258-4629
-----------------------------------------------------
Fax | 802-254-4629
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 TOWN CRIER DR
-----------------------------------------------------
City | BRATTLEBORO
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05301-8669
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-258-4629
-----------------------------------------------------
Fax | 802-254-4629
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------