Provider Demographics
NPI:1730639600
Name:TESSIER, JEREMIAH III (MASTERS DEGREE)
Entity Type:Individual
Prefix:MRS
First Name:JEREMIAH
Middle Name:
Last Name:TESSIER
Suffix:III
Gender:M
Credentials:MASTERS DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SIDLAW RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-5425
Mailing Address - Country:US
Mailing Address - Phone:978-855-5504
Mailing Address - Fax:
Practice Address - Street 1:28 SIDLAW RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-5425
Practice Address - Country:US
Practice Address - Phone:978-855-5504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health