Provider Demographics
NPI:1952002081
Name:SANCHEZ, JARED PIERCE (BA)
Entity type:Individual
Prefix:MR
First Name:JARED
Middle Name:PIERCE
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MANVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02838-1101
Mailing Address - Country:US
Mailing Address - Phone:917-994-4989
Mailing Address - Fax:
Practice Address - Street 1:299 CREEK ST UNIT D
Practice Address - Street 2:
Practice Address - City:WRENTHAM
Practice Address - State:MA
Practice Address - Zip Code:02093-1478
Practice Address - Country:US
Practice Address - Phone:781-317-9421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI390200000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health