Provider Demographics
NPI:1194975987
Name:BEJESKY, DANIEL E (MA, LPC, LISAC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:BEJESKY
Suffix:
Gender:M
Credentials:MA, LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3026 W MELINDA LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-2345
Mailing Address - Country:US
Mailing Address - Phone:602-578-4843
Mailing Address - Fax:
Practice Address - Street 1:6 E ASPEN AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-5259
Practice Address - Country:US
Practice Address - Phone:602-578-4843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-11841101YA0400X
AZLPC-12040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)