Healthcare Provider Details

I. General information

NPI: 1699554261
Provider Name (Legal Business Name): JARROD MATHEW CRISTINA M.ED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 CRESCENT ST
BROCKTON MA
02302-3110
US

IV. Provider business mailing address

135 CRANBERRY RD
WHITMAN MA
02382-1614
US

V. Phone/Fax

Practice location:
  • Phone: 508-587-5594
  • Fax: 508-584-4217
Mailing address:
  • Phone: 781-252-0081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: