Dr. Kerrie Jongeneelen
Clinical Child & Adolescent Psychologist
19 Muzzey St Ste 202a
Lexington
, Massachusetts 02421-5211
Dr. Kerrie Jongeneelen
Clinical Child & Adolescent Psychologist
19 Muzzey St Ste 202a
Lexington
, Massachusetts 02421-5211
(617) 372-5653
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Dr. Kerrie Jongeneelen
- 19 Muzzey St Ste 202a
- Lexington, MA
- Zip : 02421-5211
- Phone : (617) 372-5653
Second Address
- Dr. Kerrie Jongeneelen
- 19 Muzzey St Ste 202a
- Lexington, MA
- Zip : 02421-5211
- Phone : (617) 372-5653
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 10646 | MA |
National Provider Identifier
| NPI | 1093966624 |
|---|---|
| Provider Name | Dr. Kerrie Jongeneelen |
| First Address | Lexington, MA 02421-5211 |
| Second Address | Lexington, MA 02421-5211 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/10/2008 |
| Last Update Date | 05/02/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1301071 | GROUP # (01) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.