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Individual

JEFFREY JACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LPCC

Contact information

Practice address
2801 MARTIN LUTHER KING JR DR, CLEVELAND, OH 44104
(216) 448-6325
Mailing address
2801 MARTIN LUTHER KING JR DR, CLEVELAND, OH 44104-3815
(216) 448-6325

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
12/01/2017
Last updated
03/29/2022
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