Provider Demographics
NPI:1164969309
Name:HESSLER, JASON (CAC-AD, LCPC, LPC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HESSLER
Suffix:
Gender:M
Credentials:CAC-AD, LCPC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E BURR BLVD
Mailing Address - Street 2:
Mailing Address - City:KEARNEYSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25430-4793
Mailing Address - Country:US
Mailing Address - Phone:240-626-4199
Mailing Address - Fax:
Practice Address - Street 1:150 E BURR BLVD
Practice Address - Street 2:
Practice Address - City:KEARNEYSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25430-4793
Practice Address - Country:US
Practice Address - Phone:240-626-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2247101YP2500X
MDLC6867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional