Jd Henneberry MD LLC
Clinic/Center, Adult Mental Health in Brookline, MA. Organization (NPI-2).
NPI number1760343271
StatusActive
Last updated in NPPESNov 24, 2025
Details
- NPI
- 1760343271
- Entity type
- Organization (NPI-2)
- Legal business name
- Jd Henneberry MD LLC
- Organization subpart
- No
- Enumeration date
- Nov 24, 2025
- Certification date
- Nov 23, 2025
- Last updated
- Nov 24, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
Practice location
747 Washington StBrookline, MA 02446-2140
Phone 617-395-1591
Mailing address
747 Washington StBrookline, MA 02446-2140
Phone 405-269-1752
Authorized official
James Henneberry
Owner/Psychiatrist
4052691752
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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