Organization
GISHKIN AND ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY MARK GISHKIN MC,LPC,LISAC (CHIEF EXECUTIVE OFFICER)
(602) 708-4719
Entity
Organization
Contact information
Practice address
9445 S 50TH ST, PHOENIX, AZ 85044-5629
(602) 708-4719
(602) 680-1260
Mailing address
9445 S 50TH ST, PHOENIX, AZ 85044-5629
(602) 708-4719
(602) 680-1260
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-0181
AZ
101YP2500X
Professional Counselor
Primary
LPC-0079
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
384249
—
AZ
Enumeration date
03/11/2009
Last updated
03/11/2009
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