Individual
MR. JEROME S EHMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LISAC
Contact information
Practice address
7600 N 15TH ST STE 36, PHOENIX, AZ 85020-4327
(602) 321-0105
Mailing address
2851 E MISSION LN, PHOENIX, AZ 85028-5324
(719) 338-8535
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15151
AZ
101YM0800X
Mental Health Counselor
Primary
15151
AZ
Other
Enumeration date
01/08/2020
Last updated
03/05/2021
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