Provider Demographics
NPI:1144348236
Name:DEMPSEY, JARED PRESLEY (MA)
Entity type:Individual
Prefix:MR
First Name:JARED
Middle Name:PRESLEY
Last Name:DEMPSEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 ISLAND CLUB DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:WANDO
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8248
Mailing Address - Country:US
Mailing Address - Phone:843-324-7388
Mailing Address - Fax:
Practice Address - Street 1:CENTER FOR DRUG AND ALCOHOL PROGRAMS, MUSC
Practice Address - Street 2:67 PRESIDENT STREET
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425
Practice Address - Country:US
Practice Address - Phone:843-792-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC54201Medicaid