Clougherty, Jamie S

Clougherty, Jamie S is an individual health care provider with primary practice located at 41 Pacella Park Dr , Randolph MA 02368-1755. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Clougherty, Jamie S can be contacted via phone (781) 440-0400.

Contact Information

Primary practice address
41 Pacella Park Dr Randolph MA 02368-1755
Phone: (781) 440-0400
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1881330652
LBN Legal business name Clougherty, Jamie S
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2022
Last updated May 5th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881330652 NPPES
Massachusetts MEDICAID 110026265E

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