Provider Demographics
NPI:1790398667
Name:SLEIMAN, JACQUELINE JACK (LMHC)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:JACK
Last Name:SLEIMAN
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 1:532 PAGE STREET
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072
Mailing Address - Country:US
Mailing Address - Phone:781-755-8952
Mailing Address - Fax:781-859-4109
Practice Address - Street 1:532 PAGE STREET
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072
Practice Address - Country:US
Practice Address - Phone:781-755-8952
Practice Address - Fax:781-859-4109
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007029-1101YM0800X
MA115555-MH-CC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health