Jamie D Boghosian

Individual provider Active NPI Mental Health Counselor · Gloucester, MA

NPI 1457062655 · NPPES record last updated Jul 12, 2024

Key facts

NPI: 1457062655
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
Practice address: 3 Blackburn Ctr
Gloucester, MA 01930-2268
Phone: (978) 283-7198
NPI assigned: Dec 8, 2022
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Justice Resource Institute, Inc. Mental Health Clinic/Center (Including Community Mental Health Center) · Salem, MA · NPI 1093787095

NPD

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Justice Resource Institute, Inc.		Current since Dec 19, 2023	Accepting new patients

Locations

3 Blackburn Ctr
Gloucester, MA 01930
Phone (978) 264-3500

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X
Mental Health Counselor	101YM0800X			Yes

Addresses

Primary practice location

3 Blackburn Ctr
Gloucester, MA 01930-2268

Mailing address

3 Blackburn Ctr
Gloucester, MA 01930-2268

Other providers in Gloucester, MA

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

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.