Jill Lack

NPI 1770117442 · on the registry since 2020 · sole proprietor

Practice

Address: 199 Rosewood Dr Ste 250
Danvers, MA 01923
Phone: (978) 968-1719
Organisation at this address: Ego Therapy, Llc
Northeast Behavioral Health Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 50

Registry record

Primary taxonomy: 101YM0800X
101YM0800X
Licence states on file: MA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2020-03-02

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Massachusetts