Jacob Ty Pehrson, LAC - Counselor in Glendale, AZ

Jacob Ty Pehrson, LAC is a Counselor - Mental Health based in Glendale, Arizona. Jacob Ty Pehrson is licensed to practice in Arizona (license number LAC-20054) and his current practice location is 17505 N 79th Ave Ste 410, Glendale, Arizona. He can be reached at his office (for appointments etc.) via phone at (623) 800-7980.

NPI number for Jacob Ty Pehrson is 1457922429 and his current mailing address is 17505 N 79th Ave Ste 410, Glendale, Arizona. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1457922429.

Contact Information

Jacob Ty Pehrson, LAC
17505 N 79th Ave Ste 410,
Glendale, AZ 85308-8732
(623) 800-7980
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameJacob Ty Pehrson
GenderMale
SpecialityCounselor - Mental Health
Location17505 N 79th Ave Ste 410, Glendale, Arizona
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1457922429
  • Provider Enumeration Date: 07/09/2021
  • Last Update Date: 07/23/2021

Medical Identifiers

Medical identifiers for Jacob Ty Pehrson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1457922429NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health LAC-20054 (Arizona)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob Ty Pehrson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jacob Ty Pehrson, LAC
17505 N 79th Ave Ste 410,
Glendale, AZ 85308-8732

Ph: (623) 800-7980
Jacob Ty Pehrson, LAC
17505 N 79th Ave Ste 410,
Glendale, AZ 85308-8732

Ph: (623) 800-7980

Reviews and Comments


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