Healthcare Provider Details

I. General information

NPI: 1730233644
Provider Name (Legal Business Name): JACQUELINE LEBEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1822 N MAIN ST STE 6
FALL RIVER MA
02720-1348
US

IV. Provider business mailing address

1822 N MAIN ST STE 6
FALL RIVER MA
02720-1348
US

V. Phone/Fax

Practice location:
  • Phone: 774-929-6797
  • Fax: 508-466-6522
Mailing address:
  • Phone: 774-929-6797
  • Fax: 508-466-6522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number160073
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number160073
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: