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General NPI Number Information
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NPI Number | 1518483957
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Entity Type | Individual
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Provider Name | JENNIFER PIERCE
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Gender | Female
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 264 N MAIN ST STE 14
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-1837
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Country | US
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Telephone | 413-224-8131
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Fax |
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Provider Business Mailing Address
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Address Line | 30 MAYBROOK RD
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City | SPRINGFIELD
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State | MA
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Zip | 01129-1711
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Country | US
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Telephone | 413-348-8742
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 314100
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 123925
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License Number State | MA
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