Healthcare Provider Details

I. General information

NPI: 1821901414
Provider Name (Legal Business Name): BRANDON JEFFERY LMHC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 MAIN ST
FITCHBURG MA
01420-8007
US

IV. Provider business mailing address

PO BOX 368
ASHBURNHAM MA
01430-0368
US

V. Phone/Fax

Practice location:
  • Phone: 978-245-5139
  • Fax:
Mailing address:
  • Phone: 978-245-5139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BRANDON JEFFERY
Title or Position: OWNER
Credential: LMHC
Phone: 978-245-5139