Provider Demographics
NPI:1639493174
Name:KURTZBERG, JARED E (MA)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:E
Last Name:KURTZBERG
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 BELROSE ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-2256
Mailing Address - Country:US
Mailing Address - Phone:702-486-5080
Mailing Address - Fax:702-486-5087
Practice Address - Street 1:620 BELROSE ST
Practice Address - Street 2:SUITE 107
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-2256
Practice Address - Country:US
Practice Address - Phone:702-486-5080
Practice Address - Fax:702-486-5087
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health