Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jack Komejan, LCSW

Individual provider Clinical Social Worker · NPI 1710335542

Jack Komejan, LCSW is a Clinical Social Worker in Philadelphia, Pennsylvania. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2016
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

34TH And Civic Center Blvd
Philadelphia, PA 19104-4399
Phone: (215) 590-1136
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCS012339 (CA)

Record details

NPI number1710335542
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJune 2, 2016
Last updated in NPPESJune 2, 2016

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