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NPI Code Detail

MEDICARE: JASON CONGER LCSW, LMFT

MEDICARE: JASON CONGER LCSW, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist1159CO
21041C0700XClinical Social Worker09923511CO

General Provider Information

NPI Number : 1750783163
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON CONGER LCSW, LMFT
Provider Business Mailing Address
First Line : 4891 INDEPENDENCE ST STE 165
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-6714
Country : US
Telephone Number : 303-456-0600
Fax Number :
Provider Business Practice Location Address
First Line : 4891 INDEPENDENCE ST STE 165
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-6714
Country : US
Telephone Number : 303-456-0600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2014
Last Update Date : 11/23/2020

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