Individual
MR. JACK ALEXANDER SPERLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW LCSW
Contact information
Practice address
14 LEROY STREET, BINGHAMTON, NY 13905-4603
(607) 722-1918
(607) 724-3865
Mailing address
14 LEROY STREET, BINGHAMTON, NY 13905-4603
(607) 722-1918
(607) 724-3865
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
R0235911
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11511702
CAQH
—
01
—
135362
VALUE OPTIONS
—
Enumeration date
10/17/2006
Last updated
07/08/2007
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