Provider Demographics
NPI:1578682498
Name:LAURENZA, JENNIFER LEE (LMHC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LEE
Last Name:LAURENZA
Suffix:
Gender:F
Credentials:LMHC, LMFT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LAURENZA
Other - Last Name:RUBINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 CHARLES ELDRIDGE RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:LAKEVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02347-1388
Mailing Address - Country:US
Mailing Address - Phone:508-789-9168
Mailing Address - Fax:866-611-0597
Practice Address - Street 1:104 CHARLES ELDRIDGE RD
Practice Address - Street 2:SUITE 9
Practice Address - City:LAKEVILLE
Practice Address - State:MA
Practice Address - Zip Code:02347-1388
Practice Address - Country:US
Practice Address - Phone:508-789-9168
Practice Address - Fax:866-611-0597
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5446101YM0800X
MA1269106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist