Jirak, Jeffrey S

Jirak, Jeffrey S is an sole proprietor health care provider with primary practice located at 11851 N 51St Ave Ste B110 , Glendale AZ 85304-2823. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Jirak, Jeffrey S can be contacted via phone (480) 882-4545.

Contact Information

Primary practice address
11851 N 51St Ave Ste B110 Glendale AZ 85304-2823
Phone: (480) 882-4545
Fax: (623) 773-2267
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LISAC-10590 Arizona
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC-2320 Arizona

Profile Details

NPI number 1063565455
LBN Legal business name Jirak, Jeffrey S
Credentials LPC, LISAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 19th, 2007
Last updated May 11th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063565455 NPPES
Arizona MEDICAID 646316

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