Provider Demographics
NPI:1568996528
Name:JBW PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:JBW PSYCHOLOGICAL SERVICES LLC
Other - Org Name:ESSENTIAL INSIGHTS COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:WARKENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-693-3200
Mailing Address - Street 1:43 BROAD ST STE B206
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-2565
Mailing Address - Country:US
Mailing Address - Phone:781-693-3200
Mailing Address - Fax:844-439-7801
Practice Address - Street 1:43 BROAD ST STE B206
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-2565
Practice Address - Country:US
Practice Address - Phone:781-693-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9122103TC0700X
103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty