Provider Demographics
NPI:1134906928
Name:ROSSIGNOL, JENNIFER MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:ROSSIGNOL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03052-2317
Mailing Address - Country:US
Mailing Address - Phone:603-421-4544
Mailing Address - Fax:
Practice Address - Street 1:336 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2609
Practice Address - Country:US
Practice Address - Phone:978-674-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227558104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker