Provider Demographics
NPI:1083382568
Name:ARKEDEN, JASON TARRANT
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:TARRANT
Last Name:ARKEDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7092 MUSTANG RIM DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-4165
Mailing Address - Country:US
Mailing Address - Phone:480-283-7853
Mailing Address - Fax:
Practice Address - Street 1:7092 MUSTANG RIM DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-4165
Practice Address - Country:US
Practice Address - Phone:480-283-7853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018796101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health