Provider Demographics
NPI:1386953800
Name:BLEUER, JEREMY CALEB (BA)
Entity type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:CALEB
Last Name:BLEUER
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 1:309 W GROVE
Mailing Address - Street 2:
Mailing Address - City:COLETA
Mailing Address - State:IL
Mailing Address - Zip Code:61081-5115
Mailing Address - Country:US
Mailing Address - Phone:815-973-3420
Mailing Address - Fax:
Practice Address - Street 1:1126 HEALTHCARE DR
Practice Address - Street 2:
Practice Address - City:MOUNT CARROLL
Practice Address - State:IL
Practice Address - Zip Code:61053-1469
Practice Address - Country:US
Practice Address - Phone:815-973-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker