Organization
JP PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PUGH LICSW (PSYCHOTHERAPIST)
(781) 474-2258
Entity
Organization
Contact information
Practice address
163 HIGHLAND AVE # 1093, NEEDHAM, MA 02494-3025
(781) 474-2258
Mailing address
163 HIGHLAND AVE # 1093, NEEDHAM, MA 02494-3025
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336572288
NPI , INDIVIDUAL
—
Enumeration date
08/08/2022
Last updated
08/10/2022
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