Provider Demographics
NPI:1720427636
Name:SECTER, JACLYN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:
Last Name:SECTER
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 1:11 GROVENOR RD
Mailing Address - Street 2:#4
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2515
Mailing Address - Country:US
Mailing Address - Phone:774-437-2217
Mailing Address - Fax:
Practice Address - Street 1:11 GROVENOR RD
Practice Address - Street 2:#4
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2515
Practice Address - Country:US
Practice Address - Phone:774-437-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1168291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical