Provider Demographics
NPI:1245512342
Name:LIGUORI, JENNIFER LEA (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEA
Last Name:LIGUORI
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 1:3 SHAPE DR
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6601
Mailing Address - Country:US
Mailing Address - Phone:207-467-8930
Mailing Address - Fax:207-985-8459
Practice Address - Street 1:3 SHAPE DR
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6601
Practice Address - Country:US
Practice Address - Phone:207-467-8930
Practice Address - Fax:207-985-8459
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC13285104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker