Jeffrey S Jirak, LPC, LISAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-2320 Issued in AZ

Practice address

11851 N 51St Ave Ste B110
Glendale, AZ 85304-2823

Phone

(480) 882-4545

Fax

(623) 773-2267

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neighborhood Outreach Access to Health

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1942518550

  Mental Health

  Medicare reassignment NPD
• Neighborhood Outreach Access to Health

  • Federally Qualified Health Center (FQHC)
  • Glendale, AZ
  • NPI 1326731555
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1063565455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "480-882-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11851 N 51ST AVE STE B110",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853042823",
            "telephone_number": "480-882-4545",
            "fax_number": "623-773-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIRAK",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "LPC, LISAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2023-05-11",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-10590",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-2320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "646316",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clara L Jimenez, LPC
• George Anthony Jimenez II, PHARMD
• Melissa Jimenez, SLPA
• Tricia L Jimenez, M.A., LPC
• Yamei Jing
• JMM Ventures
• JMM Ventures, LLC
• Joel S Sellers DO LLC
• Ramanpreet Johal, DO
• Jeffrey S Johannesmeyer, DMD

• Mental Health Counselor in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.