MEDICARE: JARED HARKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	1041C0700X	NV

General Provider Information

NPI Number	:	1598189540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED HARKER

Provider Business Mailing Address
First Line	:	9190 DOUBLE DIAMOND PKWY
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89521-4842
Country	:	US
Telephone Number	:	775-200-0935
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 S GILBERT RD STE 113
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-6000
Country	:	US
Telephone Number	:	775-200-0935
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2014
Last Update Date	:	03/15/2019

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