Jared Bryson, IMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

56726 Issued in CA

Practice address

31681 Riverside Dr
Suite L
Lake Elsinore, CA 92530-7815

Phone

(951) 674-9243

Fax

(951) 674-9635

NPI assigned

Nov 3, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Water'S Edge Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meridian, ID
  • NPI 1346090594
  NPD Authorized official
• Stephen M Pumphrey Licensed Clinical Social Workers Inc

  • Clinical Social Worker
  • Laguna Hills, CA
  • NPI 1386862969
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1295988319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31681 RIVERSIDE DR",
            "address_2": "SUITE L",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307815",
            "telephone_number": "951-674-9243",
            "fax_number": "951-674-9635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31681 RIVERSIDE DR",
            "address_2": "SUITE L",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307815",
            "telephone_number": "951-674-9243",
            "fax_number": "951-674-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYSON",
        "first_name": "JARED",
        "credential": "IMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "56726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenya Brown
• Laura Lashaye Brown
• Deanna Brownson, LCS 20780
• Angela Bruce
• Robert Bryant Jr.
• Maribel Buenas
• Raul Buenrostro, LCSW
• Rochelle Bui
• Gillian Burkette, MA
• Nairobi Burks

• Mental Health Counselor in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.