Provider Demographics
NPI:1225535115
Name:LINSLEY, JANE GRAY (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:GRAY
Last Name:LINSLEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:MA
Mailing Address - Zip Code:01245-0157
Mailing Address - Country:US
Mailing Address - Phone:413-528-2627
Mailing Address - Fax:
Practice Address - Street 1:100 GOULD ROAD
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:MA
Practice Address - Zip Code:01245
Practice Address - Country:US
Practice Address - Phone:413-528-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1891101YA0400X
MA1161621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)