Provider Demographics
NPI:1942674395
Name:ZAJKOWSKI, JEFFREY SCOTT (LPC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:ZAJKOWSKI
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 E STATE ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2622
Mailing Address - Country:US
Mailing Address - Phone:815-737-8673
Mailing Address - Fax:815-708-8248
Practice Address - Street 1:7210 E STATE ST
Practice Address - Street 2:SUITE 206
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2622
Practice Address - Country:US
Practice Address - Phone:815-737-8673
Practice Address - Fax:815-708-8248
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178011494101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional