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General NPI Number Information
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NPI Number | 1073239653
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Entity Type | Organization
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Legal Business Name | WELLNESS WITH JASON DOTSON
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 159 3RD ST
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City | NEWARK
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State | NJ
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Zip | 07107-2208
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Country | US
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Telephone | 862-334-4471
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Fax |
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Provider Business Mailing Address
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Address Line | 4 S ORANGE AVE STE 1246
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-1702
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Country | US
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Telephone | 862-334-4471
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON DOTSON
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Credential | LPC, LCADC, MHD, MHS
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Telephone | 862-334-4471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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