Provider Demographics
NPI:1073670089
Name:REED, JENNIFER COLELLO (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:COLELLO
Last Name:REED
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PLIMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01566-1273
Mailing Address - Country:US
Mailing Address - Phone:508-347-1969
Mailing Address - Fax:
Practice Address - Street 1:52 CHARLTON ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-1910
Practice Address - Country:US
Practice Address - Phone:508-849-5649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2131271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical