Provider Demographics
NPI:1588928071
Name:MARCHETTI, JACQUELYN KATHLEEN
Entity type:Individual
Prefix:MS
First Name:JACQUELYN
Middle Name:KATHLEEN
Last Name:MARCHETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 NICHOLS LN
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-4646
Mailing Address - Country:US
Mailing Address - Phone:978-317-5563
Mailing Address - Fax:
Practice Address - Street 1:2 NICHOLS LN
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-4646
Practice Address - Country:US
Practice Address - Phone:978-317-5563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor