Healthcare Provider Details

I. General information

NPI: 1851634885
Provider Name (Legal Business Name): JESSICA BOVE JAMISON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 SOUTHBRIDGE STREET UNIT 2
AUBURN MA
01501
US

IV. Provider business mailing address

98 HAGGERTY RD
CHARLTON MA
01507-6525
US

V. Phone/Fax

Practice location:
  • Phone: 508-770-0511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11287
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: