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Jared G Deerhake, BSMHP
Counselor in Centralia, Illinois
NPI 1790135796

Jared G Deerhake is a Counselor based in Centralia, IL. Jared G Deerhake practices in Centralia, IL and has the professional credentials of BSMHP. The NPI Number for Jared G Deerhake is 1790135796 and holds a License No. (Illinois).

The current practice location address for Jared G Deerhake is 904 E. Martin Luther King Dr., Centralia, IL and can be reached out via phone at 618-533-1391.

Location: 904 E. Martin Luther King Dr., Centralia, IL, 62801-3058
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790135796
Provider Name
Jared G Deerhake
Credential
BSMHP
Provider Entity Type
Individual
Gender
Male
Address
904 E. Martin Luther King Dr., Centralia, IL, 62801-3058
Phone Number
618-533-1391
Fax Number
Provider Enumeration Date
06/21/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
370915481007 05 IL
institution
Provider Business Practice Location Address Details
Address
904 E. Martin Luther King Dr.
City
Centralia
State
Illinois
Zip
62801-3058
Phone Number
618-533-1391
Fax Number
person
Provider Business Mailing Address Details
Address
904 E. Martin Luther King Dr.
City
Centralia
State
Illinois
Zip
62801-3058
Phone Number
618-533-1391
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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