Provider Demographics
NPI:1972186716
Name:JULES, JEFF STEVENSON
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:STEVENSON
Last Name:JULES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CALYPSO DR
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2973
Mailing Address - Country:US
Mailing Address - Phone:508-208-2492
Mailing Address - Fax:
Practice Address - Street 1:40 CALYPSO DR
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2973
Practice Address - Country:US
Practice Address - Phone:508-208-2492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical