1972516789 NPI number — MS. JENNY MILLER SECHLER LICSW

Table of content: MS. JENNY MILLER SECHLER LICSW (NPI 1972516789)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972516789 NPI number — MS. JENNY MILLER SECHLER LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER SECHLER
Provider First Name:
JENNY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LICSW
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:
1972516789
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEEDS
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01053-0004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-586-3661
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 CENTER CT
Provider Second Line Business Practice Location Address:
SUITE 3A
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01060-3006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-585-5971
Provider Business Practice Location Address Fax Number:
413-585-5990
Provider Enumeration Date:
08/14/2006

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: 1041C0700X , with the licence number:  110817 , 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)





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