Provider Demographics
NPI:1306235361
Name:BRIEN, JEREMY LAWRENCE (BA)
Entity type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:LAWRENCE
Last Name:BRIEN
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 1:3386 COMSTOCK DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-1318
Mailing Address - Country:US
Mailing Address - Phone:775-762-2119
Mailing Address - Fax:
Practice Address - Street 1:2725 YORI AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4325
Practice Address - Country:US
Practice Address - Phone:775-329-0312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health