Provider Demographics
NPI:1700814852
Name:KAY, JENNIFER (LCSW, BCD, LICSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:KAY
Suffix:
Gender:F
Credentials:LCSW, BCD, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 STEVENS LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-8417
Mailing Address - Country:US
Mailing Address - Phone:413-528-1402
Mailing Address - Fax:413-528-1402
Practice Address - Street 1:284 MAIN STEET
Practice Address - Street 2:SUITE #5
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230
Practice Address - Country:US
Practice Address - Phone:413-528-1402
Practice Address - Fax:413-528-1402
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR015457-11041C0700X
MA1140381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical