MEDICARE: HALLEY JAKES CHOINIERE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1053878124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALLEY JAKES CHOINIERE

Provider Business Mailing Address
First Line	:	233 NEEDHAM ST
Second Line	:
City	:	NEWTON
State	:	MA
Zip	:	02464-1573
Country	:	US
Telephone Number	:	774-203-4671
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 505
Second Line	:
City	:	WRENTHAM
State	:	MA
Zip	:	02093-0505
Country	:	US
Telephone Number	:	508-590-9458
Fax Number	:	508-205-2728

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	02/13/2026

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Directions to “ HALLEY JAKES CHOINIERE ” Practice Location

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