Provider Demographics
NPI:1356035281
Name:MJV, LLC
Entity type:Organization
Organization Name:MJV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MYRLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN-VENANT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-240-7226
Mailing Address - Street 1:9 KAREN RD
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-1922
Mailing Address - Country:US
Mailing Address - Phone:617-431-8619
Mailing Address - Fax:617-256-2223
Practice Address - Street 1:9 KAREN RD
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1922
Practice Address - Country:US
Practice Address - Phone:617-431-8619
Practice Address - Fax:617-256-2223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health