Provider Demographics
NPI:1447693957
Name:JMB FAMILY COUNSELING, LLC
Entity type:Organization
Organization Name:JMB FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:MCCARTHY
Authorized Official - Last Name:BERUBE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:917-414-1371
Mailing Address - Street 1:16 MIDDLESEX AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06412-1309
Mailing Address - Country:US
Mailing Address - Phone:917-414-1371
Mailing Address - Fax:
Practice Address - Street 1:246 FEDERAL RD STE CL41
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2650
Practice Address - Country:US
Practice Address - Phone:917-414-1371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1577106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty