Jarrell, Stephen

Jarrell, Stephen is an individual health care provider with primary practice located at 2712 S Calhoun St , Fort Wayne IN 46807-1402. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Jarrell, Stephen can be contacted via phone (260) 744-4326.

Contact Information

Primary practice address
2712 S Calhoun St Fort Wayne IN 46807-1402
Phone: (260) 744-4326
Fax: (260) 744-0188
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 34001650A Indiana
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 87000362A Indiana

Profile Details

NPI number 1528105202
LBN Legal business name Jarrell, Stephen
Credentials LCSW, LCAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2007
Last updated Sep 14th, 2016 - about 8 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 1528105202 NPPES
Indiana MEDICAID 200090360A

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