Basic Information
Provider Information
NPI: 1497926307
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CURRY
FirstName: JARED
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 435 W 4TH ST
Address2:  
City: WILLIAMSPORT
State: PA
PostalCode: 177016001
CountryCode: US
TelephoneNumber: 5703227873
FaxNumber: 5703228026
Practice Location
Address1: 1800 MARKET ST
Address2:  
City: LEWISBURG
State: PA
PostalCode: 178371236
CountryCode: US
TelephoneNumber: 5705249477
FaxNumber: 5705249492
Other Information
ProviderEnumerationDate: 03/19/2008
LastUpdateDate: 03/19/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X  Y Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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