Individual
JACK VEZERIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
(401) 456-3000
Mailing address
200 HIGH SERVICE AVE, NORTH PROVIDENCE, RI 02904-5113
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
CSW04399
RI
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/01/2023
Last updated
02/02/2026
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