MEDICARE: MR. JAMES R CIRAKY M. A. LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	1557	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326036906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES R CIRAKY M. A. LPC

Provider Business Mailing Address
First Line	:	PO BOX 663
Second Line	:
City	:	HOLLY SPRINGS
State	:	GA
Zip	:	30142-0663
Country	:	US
Telephone Number	:	404-293-5654
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 RIVER PARK NORTH DR
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-7835
Country	:	US
Telephone Number	:	404-293-5654
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2005
Last Update Date	:	04/21/2025

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