Provider Demographics
NPI:1114784915
Name:JAGERSKY, IVAN
Entity type:Individual
Prefix:
First Name:IVAN
Middle Name:
Last Name:JAGERSKY
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 1:1103 CROWE ST
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3021
Mailing Address - Country:US
Mailing Address - Phone:202-285-6000
Mailing Address - Fax:
Practice Address - Street 1:7371 THOMAS BLVD # 205
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-2508
Practice Address - Country:US
Practice Address - Phone:412-876-7284
Practice Address - Fax:412-981-1475
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1409661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical