Healthcare Provider Details

I. General information

NPI: 1619938875
Provider Name (Legal Business Name): JASON F ZOELLERS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 NW OLDHAM PKWY STE 218
LEES SUMMIT MO
64081-1520
US

IV. Provider business mailing address

3929 S MAYBROOK AVE
INDEPENDENCE MO
64055-3928
US

V. Phone/Fax

Practice location:
  • Phone: 816-451-0240
  • Fax:
Mailing address:
  • Phone: 573-673-9546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2018034138
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2018034138
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: