Provider Demographics
NPI:1245305531
Name:PEGG, JEAN CAROLYN (LMHC)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:CAROLYN
Last Name:PEGG
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 1:3 NESTLES LANE
Mailing Address - Street 2:
Mailing Address - City:EAST FREETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02717
Mailing Address - Country:US
Mailing Address - Phone:508-763-5909
Mailing Address - Fax:
Practice Address - Street 1:7 DEAN ST
Practice Address - Street 2:ASSOCIATES IN BEHAVIORAL HEALTH
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780
Practice Address - Country:US
Practice Address - Phone:508-822-1690
Practice Address - Fax:508-880-5389
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMH862101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1891154Medicaid
MALM0296OtherBCBS