Provider Demographics
NPI:1225158454
Name:HANKEE, JASON (PHD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:HANKEE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 KESSLER BOULEVARD EAST DRIVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220
Mailing Address - Country:US
Mailing Address - Phone:317-762-8084
Mailing Address - Fax:317-353-3445
Practice Address - Street 1:2620 KESSLER BOULEVARD EAST DR STE 235
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2897
Practice Address - Country:US
Practice Address - Phone:317-762-8084
Practice Address - Fax:317-353-3445
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99023932A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300001690Medicaid