Provider Demographics
NPI:1962922278
Name:JEAN COUNSELING INCORPORATED
Entity type:Organization
Organization Name:JEAN COUNSELING INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SALNAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:857-246-4044
Mailing Address - Street 1:42 REVERE ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-4725
Mailing Address - Country:US
Mailing Address - Phone:857-246-4044
Mailing Address - Fax:617-545-5560
Practice Address - Street 1:42 REVERE ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148
Practice Address - Country:US
Practice Address - Phone:857-246-4044
Practice Address - Fax:617-545-5560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health