Provider Demographics
NPI:1932639507
Name:JEAN-CLAUDE, XIMAR (BA)
Entity Type:Individual
Prefix:
First Name:XIMAR
Middle Name:
Last Name:JEAN-CLAUDE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 GREW HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-4910
Mailing Address - Country:US
Mailing Address - Phone:787-704-9775
Mailing Address - Fax:
Practice Address - Street 1:607 NORTH AVE. DOOR 15, 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880
Practice Address - Country:US
Practice Address - Phone:781-395-0632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health