Provider Demographics
NPI:1265914501
Name:BAIMA, JENNIFER COLE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:COLE
Last Name:BAIMA
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 SYLVAN ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-2763
Mailing Address - Country:US
Mailing Address - Phone:888-283-1722
Mailing Address - Fax:
Practice Address - Street 1:75 SYLVAN ST STE B102
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2764
Practice Address - Country:US
Practice Address - Phone:888-283-1722
Practice Address - Fax:978-774-4389
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1068591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical