Provider Demographics
NPI:1700341781
Name:JULES, NAOMIE
Entity Type:Individual
Prefix:MS
First Name:NAOMIE
Middle Name:
Last Name:JULES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BAY DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-4182
Mailing Address - Country:US
Mailing Address - Phone:617-953-4143
Mailing Address - Fax:617-745-2703
Practice Address - Street 1:859 WILLARD ST STE 430
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7490
Practice Address - Country:US
Practice Address - Phone:617-745-2703
Practice Address - Fax:617-745-2703
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104100000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker