Provider Demographics
NPI:1063548576
Name:STERN, JARIS (PHD)
Entity type:Individual
Prefix:DR
First Name:JARIS
Middle Name:
Last Name:STERN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7641 ALPATH ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9268
Mailing Address - Country:US
Mailing Address - Phone:614-218-4071
Mailing Address - Fax:614-218-4071
Practice Address - Street 1:6495 E BROAD ST
Practice Address - Street 2:SUITE C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1541
Practice Address - Country:US
Practice Address - Phone:614-322-9760
Practice Address - Fax:614-322-9762
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH959103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist