Timothy E Jervis, CASAC-T CRPA-P
Counselor, Addiction (Substance Use Disorder) in New Rochelle, New York
1790317956- Practice location
- 20 Sickles Ave, New Rochelle, NY 10801-4030
- Phone
- 914-613-0700
- Fax
- 914-355-5425
- Last updated
- February 6, 2020
Timothy E Jervis is a Counselor, Addiction (Substance Use Disorder) based in New Rochelle, NY. Timothy E Jervis practices in New Rochelle, NY and has the professional credentials of CASAC-T CRPA-P. The NPI Number for Timothy E Jervis is 1790317956 and holds a License No. 32080 (NY). The current practice location address for Timothy E Jervis is 20 Sickles Ave, New Rochelle, NY 10801-4030 and can be reached out via phone at 914-613-0700 and via fax at 914-355-5425.
Provider Profile Details
- NPI Number
- 1790317956
- Provider Name
- Timothy E Jervis
- Credential
- CASAC-T CRPA-P
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 20 Sickles Ave, New Rochelle, NY 10801-4030
- Phone Number
- 914-613-0700
- Fax Number
- 914-355-5425
- Primary Taxonomy
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- February 6, 2020
- Last Update Date
- February 6, 2020
- Certification Date
- February 6, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 20 Sickles Ave
New Rochelle, NY 10801-4030 - City
- New Rochelle
- State
- New York
- Zip
- 10801-4030
- Phone Number
- 914-613-0700
- Fax Number
- 914-355-5425
Provider Business Mailing Address Details
- Address
- 14 Amsterdam Pl Apt 4A
Mount Vernon, NY 10553-1474 - City
- Mount Vernon
- State
- NY
- Zip
- 10553-1474
- Phone Number
- 646-271-3281
License Information
- License Number
- 32080
- License State
- NY
- Taxonomy
- Counselor, Addiction (Substance Use Disorder) · 101YA0400X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Timothy E Jervis, CASAC-T CRPA-P?
The NPI number of Timothy E Jervis, CASAC-T CRPA-P is 1790317956. It was assigned on February 6, 2020 and is currently active in the NPPES registry.
What is the specialty of Timothy E Jervis, CASAC-T CRPA-P?
Timothy E Jervis, CASAC-T CRPA-P is registered under the primary taxonomy Counselor, Addiction (Substance Use Disorder) (code 101YA0400X), licensed in NY under license number 32080.
Where does Timothy E Jervis, CASAC-T CRPA-P practice?
The practice location is 20 Sickles Ave, New Rochelle, NY 10801-4030. The office can be reached at 914-613-0700 (phone) or 914-355-5425 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1790317956 directly on the NPPES registry website.