Healthcare Provider Details

I. General information

NPI: 1245141522
Provider Name (Legal Business Name): JILLIAN KETCHEN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILLIAN BARANGER

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 TADMUCK RD STE 6
WESTFORD MA
01886-3136
US

IV. Provider business mailing address

68 TADMUCK RD STE 6
WESTFORD MA
01886-3136
US

V. Phone/Fax

Practice location:
  • Phone: 978-303-8902
  • Fax:
Mailing address:
  • Phone: 978-303-8902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10004375
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: