Provider Demographics
NPI:1447600192
Name:CHASE, JEREMEY SETH (MHC)
Entity Type:Individual
Prefix:MR
First Name:JEREMEY
Middle Name:SETH
Last Name:CHASE
Suffix:
Gender:M
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 BROADWAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3351
Mailing Address - Country:US
Mailing Address - Phone:212-966-9537
Mailing Address - Fax:212-584-5450
Practice Address - Street 1:598 BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3351
Practice Address - Country:US
Practice Address - Phone:212-966-9537
Practice Address - Fax:212-584-5450
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health