Healthcare Provider Details

I. General information

NPI: 1467912220
Provider Name (Legal Business Name): JENI LABBE, LMHC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 08/24/2020
Certification Date: 08/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 SCHOOL ST UNIT 5
WALPOLE MA
02081-2815
US

IV. Provider business mailing address

689 MAIN ST # 225
WALPOLE MA
02081-3717
US

V. Phone/Fax

Practice location:
  • Phone: 774-469-0522
  • Fax:
Mailing address:
  • Phone: 774-469-0522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JENI LYNN LABBE
Title or Position: OWNER
Credential: LMHC
Phone: 774-469-0522