Provider Demographics
NPI:1407810021
Name:NOVO, JOHN J (LMFT, LADC I)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:NOVO
Suffix:
Gender:M
Credentials:LMFT, LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 CONWAY ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-1521
Mailing Address - Country:US
Mailing Address - Phone:413-774-6301
Mailing Address - Fax:866-644-0871
Practice Address - Street 1:329 CONWAY ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-1521
Practice Address - Country:US
Practice Address - Phone:413-774-6301
Practice Address - Fax:866-644-0871
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA346101YA0400X
MA211106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA39354OtherCIGNA BEHAVIORAL HEALTH
MA24215OtherHEALTH NEW ENGLAND
MA268952000OtherMAGELLAN BEHAVIORAL HEALT
MA5329230OtherAETNA US/HEALTHCARE
MA331339OtherHARVARD PILGRIM HEALTHCAR
MA33949OtherFALLON
MA454905OtherTUFTS HEALTH PLAN