Provider Demographics
NPI:1790027324
Name:HEJDUK, ALAN J (LISW-S)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:J
Last Name:HEJDUK
Suffix:
Gender:M
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-4310
Mailing Address - Country:US
Mailing Address - Phone:216-707-3406
Mailing Address - Fax:216-707-3529
Practice Address - Street 1:12201 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4310
Practice Address - Country:US
Practice Address - Phone:216-707-3406
Practice Address - Fax:216-707-3529
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0800253 SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical