Provider Demographics
NPI:1578109872
Name:SZUMSKI, JEANNINE MARIE
Entity Type:Individual
Prefix:
First Name:JEANNINE
Middle Name:MARIE
Last Name:SZUMSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3415
Mailing Address - Country:US
Mailing Address - Phone:508-755-8990
Mailing Address - Fax:508-628-6972
Practice Address - Street 1:15 NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3415
Practice Address - Country:US
Practice Address - Phone:508-755-8990
Practice Address - Fax:508-628-6972
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)