MEDICARE: JENNIFER LEE FLETCHER LMHC

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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor	7798	MA

General Provider Information

NPI Number	:	1770715674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LEE FLETCHER LMHC

Provider Business Mailing Address
First Line	:	PO BOX 415348
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-5348
Country	:	US
Telephone Number	:	888-225-8885
Fax Number	:	508-334-1977

Provider Business Practice Location Address
First Line	:	675 MAIN ST
Second Line	:
City	:	WALTHAM
State	:	MA
Zip	:	02451-0602
Country	:	US
Telephone Number	:	781-893-2003
Fax Number	:

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

Provider Enumeration Date	:	08/12/2009
Last Update Date	:	07/21/2022

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