| Doctor Name: | MR. MATTHEW JIRAUCH |
| NPI Number: | 1063531184 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW, CSACII |
| License Number: | 1951 |
| Business Practice Address: | 909 Fee Fee Rd Maryland Heights, MO - 630433801 |
| Business Phone Number: | 3142757600 |
| Business Fax Number: | 3142758486 |
| Mailing Address: | 909 Fee Fee Rd, MARYLAND HEIGHTS |
| State: | MO |
| Postal Code: | 630433801 |
| Phone Number: | 3142757600 |
| Fax Number: | 3142758486 |
| NPI Enumeration Date: | 03/28/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1951 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |