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General NPI Number Information
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NPI Number | 1962922278
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Entity Type | Organization
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Legal Business Name | JEAN COUNSELING INCORPORATED
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 42 REVERE ST
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City | MALDEN
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State | MA
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Zip | 02148
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Country | US
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Telephone | 857-246-4044
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Fax | 617-545-5560
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Provider Business Mailing Address
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Address Line | 42 REVERE ST
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City | MALDEN
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State | MA
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Zip | 02148-4725
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Country | US
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Telephone | 857-246-4044
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Fax | 617-545-5560
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Authorized Official
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Title or Position | CEO
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Name | SALNAVE JEAN
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Credential | M.ED
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Telephone | 857-246-4044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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