Provider Demographics
NPI:1790853869
Name:HUBBARD, JAMES A (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 NEWBURG ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-3319
Mailing Address - Country:US
Mailing Address - Phone:617-325-7745
Mailing Address - Fax:
Practice Address - Street 1:30 EASTBROOK RD
Practice Address - Street 2:SUITE 302
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2048
Practice Address - Country:US
Practice Address - Phone:781-329-4579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5367101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health