Healthcare Provider Details

I. General information

NPI: 1134034945
Provider Name (Legal Business Name): JASON MOWER M.S., PPC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 N ST STE 201
ROCK SPRINGS WY
82901-5474
US

IV. Provider business mailing address

2320 MARYLAND DR
GREEN RIVER WY
82935-6110
US

V. Phone/Fax

Practice location:
  • Phone: 307-630-3466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPPC-1653
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: