Provider Demographics
NPI:1699266890
Name:MAGADA, JEFFREY MICHAEL
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:MAGADA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FEDERAL PLAZA CENTRAL STE 701
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44503-1521
Mailing Address - Country:US
Mailing Address - Phone:330-797-3995
Mailing Address - Fax:330-270-9492
Practice Address - Street 1:6 FEDERAL PLAZA CENTRAL STE 701
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44503-1521
Practice Address - Country:US
Practice Address - Phone:330-797-3995
Practice Address - Fax:330-270-9492
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker