Provider Demographics
NPI:1366844425
Name:ENCK, JARRETT (MA)
Entity Type:Individual
Prefix:MR
First Name:JARRETT
Middle Name:
Last Name:ENCK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-7079
Mailing Address - Country:US
Mailing Address - Phone:603-520-4526
Mailing Address - Fax:
Practice Address - Street 1:354 WAVERLY ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-7079
Practice Address - Country:US
Practice Address - Phone:603-520-4526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health