Provider Demographics
NPI:1790197333
Name:LENCI, JESSICA STILLMAN (MA)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:STILLMAN
Last Name:LENCI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 WAHSINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930
Mailing Address - Country:US
Mailing Address - Phone:978-283-0296
Mailing Address - Fax:
Practice Address - Street 1:283 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-4849
Practice Address - Country:US
Practice Address - Phone:978-283-0296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health