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NPI Code Detail

MEDICARE: JASON WOODS LMHC

MEDICARE: JASON WOODS LMHC
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
1101YM0800XMental Health Counselor39003343AIN

General Provider Information

NPI Number : 1538644083
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON WOODS LMHC
Provider Business Mailing Address
First Line : 645 S ROGERS ST
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-2353
Country : US
Telephone Number : 812-339-1691
Fax Number :
Provider Business Practice Location Address
First Line : 35 BOB BABBS DR
Second Line :
City : SPENCER
State : IN
Zip : 47460-6828
Country : US
Telephone Number : 812-829-4871
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2018
Last Update Date : 10/01/2018

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