Provider Demographics
NPI:1386266989
Name:GUERTIN, JARED PAUL (BA)
Entity type:Individual
Prefix:MR
First Name:JARED
Middle Name:PAUL
Last Name:GUERTIN
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 1:59 ROCCO DR
Mailing Address - Street 2:
Mailing Address - City:BLACKSTONE
Mailing Address - State:MA
Mailing Address - Zip Code:01504-1373
Mailing Address - Country:US
Mailing Address - Phone:508-244-7467
Mailing Address - Fax:
Practice Address - Street 1:3 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2001
Practice Address - Country:US
Practice Address - Phone:508-473-2178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health