Provider Demographics
NPI:1376696880
Name:SCHLENKER, JESSICA TARYN (MS)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:TARYN
Last Name:SCHLENKER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 MIDDLESEX ST
Mailing Address - Street 2:SUITE 226
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1569
Mailing Address - Country:US
Mailing Address - Phone:978-703-0731
Mailing Address - Fax:978-703-1447
Practice Address - Street 1:55 MIDDLESEX ST
Practice Address - Street 2:SUITE 226
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1569
Practice Address - Country:US
Practice Address - Phone:978-703-0731
Practice Address - Fax:978-703-1447
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA6972101Y00000X
MA1353106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist