Grossman, Jon Birdell

Grossman, Jon Birdell is an individual health care provider with primary practice located at 1300 N 12Th St Ste 550 , Phoenix AZ 85006-2820. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Grossman, Jon Birdell can be contacted via phone (602) 410-6637.

Contact Information

Primary practice address
1300 N 12Th St Ste 550 Phoenix AZ 85006-2820
Fax: (480) 609-9552
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X LMFT0182 Arizona
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW0754 Arizona

Profile Details

NPI number 1164575486
LBN Legal business name Grossman, Jon Birdell
Credentials M.S.W.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2007
Last updated Nov 30th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164575486 NPPES
Arizona Other 964579 AHCCS PROVIDER ID

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