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NPI Code Detail

MEDICARE: MR. JASON PAUL WOOD LPCC

MEDICARE: MR. JASON PAUL WOOD LPCC
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
1101YP2500XProfessional Counselor1118-5-1-21-443ND
2101YP2500XProfessional CounselorCC03555MN

General Provider Information

NPI Number : 1548770548
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON PAUL WOOD LPCC
Provider Business Mailing Address
First Line : 1615 17TH AVE S
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-5372
Country : US
Telephone Number : 701-795-8550
Fax Number :
Provider Business Practice Location Address
First Line : 1615 17TH AVE S
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-5372
Country : US
Telephone Number : 701-795-8550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2017
Last Update Date : 01/02/2026

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Directions to “ MR. JASON PAUL WOOD LPCC” Practice Location

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