Provider Demographics
NPI:1144492315
Name:JARECKI, MICHAEL (LMHP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:JARECKI
Suffix:
Gender:M
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5314 READ ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-2445
Mailing Address - Country:US
Mailing Address - Phone:402-573-1063
Mailing Address - Fax:
Practice Address - Street 1:234 SAINT JOSEPH DR
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-7988
Practice Address - Country:US
Practice Address - Phone:740-266-6461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1460101YM0800X
NE1327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health