=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952909814
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JASON PAUL JONES LCSWA, LCAS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2020
-----------------------------------------------------
Last Update Date | 08/17/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 77 CENTRAL AVE STE A
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28801-2452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-778-2973
-----------------------------------------------------
Fax | 765-392-4263
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4 MEADOW BROOK DR
-----------------------------------------------------
City | FLETCHER
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28732-9101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-777-0692
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 26507
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | P015026
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------