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General NPI Number Information
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NPI Number | 1760343271
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Entity Type | Organization
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Legal Business Name | JD HENNEBERRY MD LLC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 747 WASHINGTON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-2140
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Country | US
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Telephone | 617-395-1591
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Fax |
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Provider Business Mailing Address
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Address Line | 747 WASHINGTON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-2140
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Country | US
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Telephone | 405-269-1752
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHIATRIST
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Name | JAMES HENNEBERRY
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Credential | MD
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Telephone | 405-269-1752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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