Provider Demographics
NPI:1003576935
Name:HENIN, JOCELYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:
Last Name:HENIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 HINCKLEY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-2710
Mailing Address - Country:US
Mailing Address - Phone:917-710-7585
Mailing Address - Fax:
Practice Address - Street 1:60 MAPLE ST STE 1C
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1248
Practice Address - Country:US
Practice Address - Phone:917-710-7585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2022-03-18
Deactivation Date:2022-02-10
Deactivation Code:
Reactivation Date:2022-03-17
Provider Licenses
StateLicense IDTaxonomies
NY021472103TC0700X
MA10796103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical