Provider Demographics
NPI:1467182238
Name:BERNSTEIN RANGAN, JENNY SARAH (MA, LMT)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:SARAH
Last Name:BERNSTEIN RANGAN
Suffix:
Gender:F
Credentials:MA, LMT
Other - Prefix:MRS
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:RANGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMT
Mailing Address - Street 1:43 WESTERN AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-3646
Mailing Address - Country:US
Mailing Address - Phone:978-317-8617
Mailing Address - Fax:
Practice Address - Street 1:3 BLACKBURN CTR
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-2268
Practice Address - Country:US
Practice Address - Phone:978-491-6679
Practice Address - Fax:978-281-7793
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health