Healthcare Provider Details

I. General information

NPI: 1306099924
Provider Name (Legal Business Name): JENNIFER LYNNE CABRAL MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 09/15/2021
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SAMOSETT DR
SOUTH DARTMOUTH MA
02748-1226
US

IV. Provider business mailing address

9 SAMOSETT DR
SOUTH DARTMOUTH MA
02748-1226
US

V. Phone/Fax

Practice location:
  • Phone: 508-525-0255
  • Fax:
Mailing address:
  • Phone: 508-525-0255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8097
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: