Individual
JEFFREY S JIRAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, LISAC
Contact information
Practice address
11851 N 51ST AVE STE B110, GLENDALE, AZ 85304-2823
(480) 882-4545
(623) 773-2267
Mailing address
7500 N DREAMY DRAW DR STE 145, PHOENIX, AZ 85020-4668
(480) 882-4545
(480) 882-5814
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-10590
AZ
101YM0800X
Mental Health Counselor
Primary
LPC-2320
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
646316
—
AZ
Enumeration date
01/19/2007
Last updated
05/11/2023
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