Provider Demographics
NPI:1700637816
Name:MCDONALD, JARED M
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:M
Last Name:MCDONALD
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 1:24 ESSEX ST UNIT 306
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-5601
Mailing Address - Country:US
Mailing Address - Phone:978-994-4474
Mailing Address - Fax:
Practice Address - Street 1:55 TOZER RD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-5515
Practice Address - Country:US
Practice Address - Phone:978-969-2894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst