Provider Demographics
NPI:1952394850
Name:JAYNES, MARY C (LMHC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:C
Last Name:JAYNES
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 1:21 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-2164
Mailing Address - Country:US
Mailing Address - Phone:978-568-1221
Mailing Address - Fax:
Practice Address - Street 1:21 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-2164
Practice Address - Country:US
Practice Address - Phone:978-568-1221
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2135576OtherCIGNA BEHAVIORAL HEALTH
MA356440OtherTRICARE
MA550010005799OtherPACIFICARE BEHAVIORAL
MA1032870OtherBEACON HEALTH STRATEGIES
MALM0791OtherBLUE CROSS & BLUE SHIELD