JACK KOMEJAN L.C.S.W.
NPI 1710335542
Social Worker - Clinical in Philadelphia, PA

Active since June 02, 2016
34TH AND CIVIC CENTER BOULEVARD, PHILADELPHIA, PA 19104(215) 590-1136 Get Directions Write a Review

NPPES record last updated: June 2, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jack Komejan L.c.s.w. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK KOMEJAN L.C.S.W. (NPI 1710335542) is an individual clinical provider in Philadelphia, Pennsylvania, licensed in California (LCS012339) and active in the NPI registry since June 2016.

NPPES Registry Identity

NPI1710335542
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJACK KOMEJANCredential: L.C.S.W.
Location Address34TH AND CIVIC CENTER BOULEVARDPhiladelphia, PA 19104-4399
Mailing Address402 W Durham StPhiladelphia, PA 19119-2910 · (650) 218-8293
Sole ProprietorYes
Enumeration DateJune 2, 2016
NPI 1710335542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in CA · LCS012339
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
34TH AND CIVIC CENTER BOULEVARD, Philadelphia, PA 19104

Other Identifiers 1

OtherLS012339CA · California Board Of Behavioral Sciences

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
34TH AND CIVIC CENTER BOULEVARD
PHILADELPHIA, PA 19104
Nurse Practitioner (Family)
34TH AND CIVIC CENTER BOULEVARD, CHILDREN'S HOSPITAL OF PHILA, DIVISION OF ONCOLOGY
PHILADELPHIA, PA 19104
Nurse Practitioner (Pediatrics)
34TH AND CIVIC CENTER BOULEVARD
PHILADELPHIA, PA 19104
Nurse Practitioner (Family)
34TH AND CIVIC CENTER BOULEVARD, 2ND FLOOR, WOOD BUILDING, ORTHOPEDICS
PHILADELPHIA, PA 19104
Nurse Practitioner (Pediatrics)
34TH AND CIVIC CENTER BOULEVARD
PHILADELPHIA, PA 19104
Registered Nurse (Pediatrics)
34TH AND CIVIC CENTER BOULEVARD
PHILADELPHIA, PA 19104
Nurse Practitioner (Pediatrics)
34TH AND CIVIC CENTER BOULEVARD
PHILADELPHIA, PA 19104

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Komejan's NPI number?

The NPI number for Jack Komejan is 1710335542. It was assigned to this individual provider in the NPPES registry on June 2, 2016.

Where is Jack Komejan located?

Jack Komejan practices at 34th And Civic Center Boulevard, Philadelphia, PA 19104. The listed phone number is (215) 590-1136.

What is Jack Komejan's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Jack Komejan was last updated on June 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.