Provider Demographics
NPI:1326467911
Name:BLEWETT, JENNIFER GRACE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:GRACE
Last Name:BLEWETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:16 BLOSSOM ST
Mailing Address - Street 2:WEST END CLINIC
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-3104
Mailing Address - Country:US
Mailing Address - Phone:617-643-6919
Mailing Address - Fax:617-248-0070
Practice Address - Street 1:16 BLOSSOM ST
Practice Address - Street 2:WEST END CLINIC
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3104
Practice Address - Country:US
Practice Address - Phone:617-643-6919
Practice Address - Fax:617-248-0070
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2187621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical