Provider Demographics
NPI:1073239653
Name:WELLNESS WITH JASON DOTSON
Entity Type:Organization
Organization Name:WELLNESS WITH JASON DOTSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCADC, MHD, MHS
Authorized Official - Phone:862-334-4471
Mailing Address - Street 1:4 S ORANGE AVE STE 1246
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1702
Mailing Address - Country:US
Mailing Address - Phone:862-334-4471
Mailing Address - Fax:
Practice Address - Street 1:159 3RD ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2208
Practice Address - Country:US
Practice Address - Phone:862-334-4471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty