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Jeremy Travis Provost
Counselor in Plymouth, Massachusetts
NPI 1659635183

Jeremy Travis Provost is a Counselor based in Plymouth, MA. Jeremy Travis Provost practices in Plymouth, MA. The NPI Number for Jeremy Travis Provost is 1659635183 and holds a License No. (Massachusetts).

The current practice location address for Jeremy Travis Provost is 900 Ship Pond Road, Plymouth, MA and can be reached out via phone at 617-686-7901.

Location: 900 Ship Pond Road, Plymouth, MA, 02360
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659635183
Provider Name
Jeremy Travis Provost
Credential
Provider Entity Type
Individual
Gender
Male
Address
900 Ship Pond Road, Plymouth, MA, 02360
Phone Number
617-686-7901
Fax Number
Provider Enumeration Date
06/29/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
900 Ship Pond Road
City
Plymouth
State
Massachusetts
Zip
02360
Phone Number
617-686-7901
Fax Number
person
Provider Business Mailing Address Details
Address
900 Ship Pond Road
City
Plymouth
State
Massachusetts
Zip
02360
Phone Number
617-686-7901
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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