MEDICARE: JENNIFER ROBERTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker	118371-SW-LICSW	MA

General Provider Information

NPI Number	:	1245714641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ROBERTS

Provider Business Mailing Address
First Line	:	609 WEBSTER ST
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-1196
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	609 WEBSTER ST
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02494-1196
Country	:	US
Telephone Number	:	781-455-0800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2018
Last Update Date	:	09/20/2018

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Directions to “ JENNIFER ROBERTS ” Practice Location

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