Provider Demographics
NPI:1144712936
Name:BEARCE, JACQUELINE (EDD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:
Last Name:BEARCE
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 PONDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3258
Mailing Address - Country:US
Mailing Address - Phone:413-253-3987
Mailing Address - Fax:
Practice Address - Street 1:132 PONDVIEW DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-3258
Practice Address - Country:US
Practice Address - Phone:413-253-3987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3422103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling