Provider Demographics
NPI:1417523994
Name:JERRY-WOLCOTT, JOCELYN ANNE (LICSW)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:ANNE
Last Name:JERRY-WOLCOTT
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 1:48 FERRIN RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03303-4139
Mailing Address - Country:US
Mailing Address - Phone:603-496-7570
Mailing Address - Fax:
Practice Address - Street 1:48 FERRIN RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03303-4139
Practice Address - Country:US
Practice Address - Phone:603-496-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1065091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical