Provider Demographics
NPI:1720360654
Name:NOVOSON, JESSICA (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:NOVOSON
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 WASHINGTON ST STE 14
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1696
Mailing Address - Country:US
Mailing Address - Phone:781-561-8081
Mailing Address - Fax:833-263-1965
Practice Address - Street 1:1112 WASHINGTON ST STE 14
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1696
Practice Address - Country:US
Practice Address - Phone:781-561-8081
Practice Address - Fax:833-263-1965
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
MA9104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)