MEDICARE: JACQUELYNNE ROSE SAWYER LCSW

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	106S00000X	Behavior Technician
2	101YM0800X	Mental Health Counselor	LCSW230432	MA

General Provider Information

NPI Number	:	1306451547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELYNNE ROSE SAWYER LCSW

Provider Business Mailing Address
First Line	:	8 ATWOOD DR
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-4266
Country	:	US
Telephone Number	:	818-240-6780
Fax Number	:	818-241-6853

Provider Business Practice Location Address
First Line	:	8 ATWOOD DR
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-4266
Country	:	US
Telephone Number	:	413-586-5555
Fax Number	:

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

Provider Enumeration Date	:	09/14/2020
Last Update Date	:	03/12/2026

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