Provider Demographics
NPI:1093242265
Name:VAN ZEE, JASON (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:VAN ZEE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5415 NW 88TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2951
Mailing Address - Country:US
Mailing Address - Phone:515-727-1338
Mailing Address - Fax:515-727-1340
Practice Address - Street 1:5415 NW 88TH ST STE 100
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2951
Practice Address - Country:US
Practice Address - Phone:515-727-1338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077363101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health