Provider Demographics
NPI:1013230853
Name:KIRKPATRICK, JASON H (LPC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:H
Last Name:KIRKPATRICK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4801 WELDON SPRING PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WELDON SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:63304-9101
Mailing Address - Country:US
Mailing Address - Phone:636-474-9164
Mailing Address - Fax:636-949-0729
Practice Address - Street 1:4801 WELDON SPRING PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-9101
Practice Address - Country:US
Practice Address - Phone:636-474-9164
Practice Address - Fax:636-949-0729
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2006013032101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional