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
Phone: (602) 410-6637
Fax: (480) 609-9552
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1164575486 | NPPES |
Arizona | Other | 964579 | AHCCS PROVIDER ID |
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