Provider Demographics
NPI:1972516789
Name:MILLER SECHLER, JENNY (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JENNY
Middle Name:
Last Name:MILLER SECHLER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:MA
Mailing Address - Zip Code:01053-0004
Mailing Address - Country:US
Mailing Address - Phone:413-586-3661
Mailing Address - Fax:
Practice Address - Street 1:19 CENTER CT
Practice Address - Street 2:SUITE 3A
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3006
Practice Address - Country:US
Practice Address - Phone:413-585-5971
Practice Address - Fax:413-585-5990
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1108171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP23581Medicare ID - Type Unspecified
MAP2358102Medicare UPIN