Provider Demographics
NPI:1578344024
Name:LEMBO, JESSICA DALY (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:DALY
Last Name:LEMBO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MARLBORO RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MA
Mailing Address - Zip Code:01503-1304
Mailing Address - Country:US
Mailing Address - Phone:774-262-1377
Mailing Address - Fax:
Practice Address - Street 1:359 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1511
Practice Address - Country:US
Practice Address - Phone:508-203-6770
Practice Address - Fax:508-519-0210
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227014101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor