Provider Demographics
NPI:1013187251
Name:DEBRA L JAROUSKY, LMHC,LLC
Entity Type:Organization
Organization Name:DEBRA L JAROUSKY, LMHC,LLC
Other - Org Name:DEBRA L JAROUSKY, LMHC,LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JAROUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC,LLC
Authorized Official - Phone:508-695-3885
Mailing Address - Street 1:17 ABBIE LN
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-6278
Mailing Address - Country:US
Mailing Address - Phone:774-219-3123
Mailing Address - Fax:
Practice Address - Street 1:30 MAN MAR DR STE 13
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2271
Practice Address - Country:US
Practice Address - Phone:508-695-3885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3879101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty