Provider Demographics
NPI:1437721883
Name:HOGAN, JEANNE-MARIE (LMHC, CRC)
Entity type:Individual
Prefix:
First Name:JEANNE-MARIE
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:LMHC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1133
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809-0903
Mailing Address - Country:US
Mailing Address - Phone:631-905-6574
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1133
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-0903
Practice Address - Country:US
Practice Address - Phone:631-905-6574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA12355-MH-CC101YM0800X
MA12355101YM0800X
RIMHC01213101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health