Provider Demographics
NPI:1326674417
Name:KINGSTON, JEAN YIH
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:YIH
Last Name:KINGSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/O JEAN KINGSTON
Mailing Address - Street 2:16 CHESTNUT ST
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-3019
Mailing Address - Country:US
Mailing Address - Phone:617-909-2065
Mailing Address - Fax:
Practice Address - Street 1:DCS MENTAL HEALTH MEDFORD
Practice Address - Street 2:151 MYSTIC AVENUE
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-4632
Practice Address - Country:US
Practice Address - Phone:781-396-1199
Practice Address - Fax:781-396-1439
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health