Provider Demographics
NPI:1629135611
Name:HERRING, JESSIE (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:HERRING
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CAMBRIDGE ST STE 230
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-3767
Mailing Address - Country:US
Mailing Address - Phone:817-221-3180
Mailing Address - Fax:781-347-1899
Practice Address - Street 1:101 CAMBRIDGE ST STE 230
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-3767
Practice Address - Country:US
Practice Address - Phone:781-212-3180
Practice Address - Fax:781-347-1899
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6227101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health