Provider Demographics
NPI:1164232682
Name:KIRKSEY, JASON (QMHS)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:KIRKSEY
Suffix:
Gender:M
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23660 MILES RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5461
Mailing Address - Country:US
Mailing Address - Phone:216-312-7678
Mailing Address - Fax:
Practice Address - Street 1:23660 MILES RD STE 100
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5461
Practice Address - Country:US
Practice Address - Phone:216-312-7678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator