Provider Demographics
NPI:1003192097
Name:CONNIFF, JENNIFER ROBINETTE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ROBINETTE
Last Name:CONNIFF
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 HOLT RD
Mailing Address - Street 2:
Mailing Address - City:BOURNE
Mailing Address - State:MA
Mailing Address - Zip Code:02532-3434
Mailing Address - Country:US
Mailing Address - Phone:774-810-0010
Mailing Address - Fax:508-445-0077
Practice Address - Street 1:32 HOLT RD
Practice Address - Street 2:
Practice Address - City:BOURNE
Practice Address - State:MA
Practice Address - Zip Code:02532-3434
Practice Address - Country:US
Practice Address - Phone:774-810-0010
Practice Address - Fax:508-445-0077
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-23
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2192951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical