1447555289 NPI number — MS. JENNIFER LEE KAY LCSW

Table of content: MS. JENNIFER LEE KAY LCSW (NPI 1447555289)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447555289 NPI number — MS. JENNIFER LEE KAY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAY
Provider First Name:
JENNIFER
Provider Middle Name:
LEE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447555289
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 AMORY ST 02130
Provider Second Line Business Mailing Address:
THOM CHILD BOSTON METRO EARLY INTERVENTION
Provider Business Mailing Address City Name:
JAMAICA PLAIN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-383-6522
Provider Business Mailing Address Fax Number:
617-383-6320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THOM CHILD BOSTON METRO EARLY INTERVENTION 555 AMORY ST
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
JAMAICA PLAIN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-383-6522
Provider Business Practice Location Address Fax Number:
617-383-6320
Provider Enumeration Date:
01/25/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  216460 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)