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General NPI Number Information
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NPI Number | 1710807359
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Entity Type | Individual
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Provider Name | JAELEENE DESTINY NUNEZ
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Gender | Female
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 29 E MOUNTAIN ST
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City | WORCESTER
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State | MA
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Zip | 01606-1400
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Country | US
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Telephone | 508-755-0556
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Fax |
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Provider Business Mailing Address
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Address Line | 74 FLORENCE ST APT 2
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City | WORCESTER
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State | MA
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Zip | 01603-2742
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Country | US
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Telephone | 978-237-1007
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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 |
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License Number State |
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