Provider Demographics
NPI:1285770107
Name:BARBOUR, JACQUES T (LMHC)
Entity type:Individual
Prefix:
First Name:JACQUES
Middle Name:T
Last Name:BARBOUR
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 DEAN ST STE 6
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2766
Mailing Address - Country:US
Mailing Address - Phone:508-837-0790
Mailing Address - Fax:508-796-6130
Practice Address - Street 1:152 DEAN ST STE 6
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2766
Practice Address - Country:US
Practice Address - Phone:508-837-0790
Practice Address - Fax:508-796-6130
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4368156FX1800X
MA6306101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician