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

Jared G Deerhake, BSMHP

Individual provider Counselor · NPI 1790135796

Jared G Deerhake, BSMHP is a Counselor in Centralia, Illinois. Registered with an NPI since 2016.

In the registry since
2016

Practice location Address checks out

904 E Martin Luther King Dr
Centralia, IL 62801-3058
Phone: (618) 533-1391
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X

Record details

NPI number1790135796
Entity typeIndividual (Type 1)
GenderMale
Credentials BSMHP
Sole proprietorNo
NPI enumeratedJune 21, 2016
Last updated in NPPESJune 21, 2016

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