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General NPI Number Information
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NPI Number | 1679216816
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Entity Type | Organization
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Legal Business Name | JENNIFER K. BERTONCINI, LICSW, LLC.
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 80 WASHINGTON ST STE C17
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City | NORWELL
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State | MA
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Zip | 02061-1729
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Country | US
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Telephone | 718-424-0303
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Fax | 781-261-9663
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Provider Business Mailing Address
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Address Line | 218 CROSS ST
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City | HANOVER
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State | MA
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Zip | 02339-2663
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Country | US
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Telephone | 617-721-2212
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Fax | 781-261-9633
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KATHLEEN ANN SOUTHERN
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Credential |
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Telephone | 978-993-7168
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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 |
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License Number State |
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