Provider Demographics
NPI:1730357138
Name:GIRARD, JAY E (LCSW)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:E
Last Name:GIRARD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 BUSINESS CIR
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1778
Mailing Address - Country:US
Mailing Address - Phone:205-510-2780
Mailing Address - Fax:
Practice Address - Street 1:333 BUSINESS CIR
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1778
Practice Address - Country:US
Practice Address - Phone:205-510-2780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1908C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical