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General NPI Number Information
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NPI Number | 1891686994
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Entity Type | Individual
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Provider Name | JASON JIAQI LI PHD
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Gender | Male
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 801 E DOUGLAS AVE FL 2
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City | WICHITA
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State | KS
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Zip | 67202-3548
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Country | US
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Telephone | 646-941-7645
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Fax | 929-596-7897
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Provider Business Mailing Address
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Address Line | 13233 E BRIDLEWOOD CT
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City | WICHITA
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State | KS
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Zip | 67230-1799
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Country | US
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Telephone | 316-689-1400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LCPC03645
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License Number State | KS
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