Jennifer Puccio, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

123723 Issued in MA

Practice address

382 W Main St Ste 203
Northborough, MA 01532-2157

Phone

(508) 202-1063

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Meta Life Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northborough, MA
  • NPI 1003536921
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1053872473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2824",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017032824",
            "telephone_number": "508-202-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 W MAIN ST STE 203",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322157",
            "telephone_number": "508-202-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCCIO",
        "first_name": "JENNIFER",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "123723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheri Mei Li Praseuth, O.D.
• Premier Live-Ins, Inc.
• Howard Marshall Price, M.D.
• Paula-Ann Marie Pricken, PH.D.
• Thomas Psyris
• Saqib N Qureshi, M.D.
• Mary Katherine Ragno
• Aruna Ramesh, DMD
• Kathleen T Randall, LMHC, EMDR
• Jennifer Ray, M.S., CCC-SLP

• Clinical Social Worker in Northborough, MA
• Providers in Northborough, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.