Jessica I Agenor

Individual provider Active NPI Mental Health Counselor · Peabody, MA

NPI 1093460370 · NPPES record last updated Feb 15, 2022

Key facts

NPI
1093460370
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
1R Newbury St Ste 401
Peabody, MA 01960-3816
Phone
(671) 804-2773
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

1R Newbury St Ste 401
Peabody, MA 01960-3816

Mailing address

73 Porter St Apt 3
Malden, MA 02148-2872
Phone (781) 957-8713

Other providers in Peabody, MA

All providers in Peabody, MA · Mental Health Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.