Provider Demographics
NPI:1811421506
Name:MASSANARI, JARED (NCLPC)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:MASSANARI
Suffix:
Gender:M
Credentials:NCLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18958
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28814-0958
Mailing Address - Country:US
Mailing Address - Phone:828-251-1948
Mailing Address - Fax:
Practice Address - Street 1:150 CHATHAM RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-3361
Practice Address - Country:US
Practice Address - Phone:828-251-1948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2280101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor