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NPI Code Detail

MEDICARE: JEN MALCOLM-BROWN, PLLC

MEDICARE: JEN MALCOLM-BROWN, PLLC
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
1261QM0850XAdult Mental Health Clinic/Center
2261QM0855XAdolescent and Children Mental Health Clinic/Center
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1902684418
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEN MALCOLM-BROWN, PLLC
Provider Business Mailing Address
First Line : 72 WENDELL RD
Second Line :
City : SHUTESBURY
State : MA
Zip : 01072-9716
Country : US
Telephone Number : 413-450-0001
Fax Number : 413-450-0009
Provider Business Practice Location Address
First Line : 110 N HILLSIDE RD STE 21
Second Line :
City : SOUTH DEERFIELD
State : MA
Zip : 01373-9727
Country : US
Telephone Number : 413-450-0001
Fax Number : 413-450-0009
Authorized Official
Title or Position : MANAGER/OWNER
Name : MS. JENNIFER E MALCOLM-BROWN
Credential : LICSW
Telephone Number : 413-450-0001
Provider Enumeration Date : 09/18/2023
Last Update Date : 09/18/2023

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Directions to “JEN MALCOLM-BROWN, PLLC ” Practice Location

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