Provider Demographics
NPI:1366086860
Name:SALERNO, JENNIFER EVELYN (LICSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:EVELYN
Last Name:SALERNO
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 1:86 HILLTOP AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-2811
Mailing Address - Country:US
Mailing Address - Phone:484-273-9295
Mailing Address - Fax:
Practice Address - Street 1:989 RESERVOIR AVE STE 201
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-5138
Practice Address - Country:US
Practice Address - Phone:401-414-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW036291041C0700X
COCSW.099287661041C0700X
RICSW023201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical