Provider Demographics
NPI:1649413519
Name:MESI, JENNIFER GREENWOOD (LMSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GREENWOOD
Last Name:MESI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 DANGELO PKWY
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NY
Mailing Address - Zip Code:14414-9426
Mailing Address - Country:US
Mailing Address - Phone:585-226-9682
Mailing Address - Fax:
Practice Address - Street 1:2 TOWNLINE CIR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2536
Practice Address - Country:US
Practice Address - Phone:585-442-6420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051643-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker