Healthcare Provider Details

I. General information

NPI: 1730510009
Provider Name (Legal Business Name): JASON HOVEY LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 05/11/2020
Certification Date: 05/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 TIDEWATER COLONY DR SUITE 1A
ANNAPOLIS MD
21401-2101
US

IV. Provider business mailing address

2007 TIDEWATER COLONY DR SUITE 1A
ANNAPOLIS MD
21401-2101
US

V. Phone/Fax

Practice location:
  • Phone: 410-294-9300
  • Fax:
Mailing address:
  • Phone: 410-294-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLC6340
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC6340
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC6340
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberLC6340
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLC6340
License Number StateMD
# 6
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC6340
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: