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General NPI Number Information
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NPI Number | 1649797119
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Entity Type | Individual
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Provider Name | JENNY VOUMARD LICSW
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Gender | Female
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 111 EDGARTOWN ROAD
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City | VINEYARD HAVEN
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State | MA
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Zip | 02568
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Country | US
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Telephone | 508-693-7900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 683
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City | WEST TISBURY
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State | MA
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Zip | 02575-0683
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Country | US
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Telephone | 914-806-4078
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 097117
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License Number State | NY
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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 | 123617
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License Number State | MA
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