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General NPI Number Information
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NPI Number | 1770721524
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Entity Type | Individual
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Provider Name | JENNIFER DUNPHY LICSW
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Gender | Female
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 309 BELMONT ST
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City | WORCESTER
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State | MA
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Zip | 01604-1059
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Country | US
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Telephone | 508-368-3625
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Fax | 508-368-0578
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Provider Business Mailing Address
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Address Line | 309 BELMONT ST
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City | WORCESTER
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State | MA
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Zip | 01604-1059
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Country | US
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Telephone | 508-368-3625
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Fax | 508-368-0578
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS 27762
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ASW23851
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | ISW02386
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License Number State | RI
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1237254995-SW-LICSW
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License Number State | MA
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