Provider Demographics
NPI:1891440772
Name:GOLDSTONE, JEAN (LMHC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:GOLDSTONE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HOBART RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-6603
Mailing Address - Country:US
Mailing Address - Phone:617-448-6342
Mailing Address - Fax:
Practice Address - Street 1:16 HOBART RD
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-6603
Practice Address - Country:US
Practice Address - Phone:617-448-6342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5075101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health