Provider Demographics
NPI:1609461417
Name:JESSICA SENECAL- BENNETT
Entity Type:Organization
Organization Name:JESSICA SENECAL- BENNETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICSW
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SENECAL-BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-388-1827
Mailing Address - Street 1:8 FEDERAL LN
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-2207
Mailing Address - Country:US
Mailing Address - Phone:413-388-1827
Mailing Address - Fax:
Practice Address - Street 1:8 FEDERAL LN
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-2207
Practice Address - Country:US
Practice Address - Phone:413-388-1827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty