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General NPI Number Information
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NPI Number | 1649160656
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Entity Type | Organization
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Legal Business Name | JASPER PSYCHOTHERAPY & CO. PC
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 5540 CENTERVIEW DR STE 200
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City | RALEIGH
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State | NC
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Zip | 27606-3386
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Country | US
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Telephone | 910-275-4862
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Fax |
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Provider Business Mailing Address
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Address Line | 370 ALLISTER DR UNIT 401
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City | RALEIGH
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State | NC
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Zip | 27609-7269
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYDNEY JASPER
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Credential | LCMHC, CYMHS
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Telephone | 910-275-4862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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