Provider Demographics
NPI:1346329877
Name:BRANSON, JASON (LPC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:BRANSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 W PARK BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-2590
Mailing Address - Country:US
Mailing Address - Phone:972-447-8224
Mailing Address - Fax:972-767-3532
Practice Address - Street 1:5055 W PARK BLVD STE 400
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-2590
Practice Address - Country:US
Practice Address - Phone:972-447-8224
Practice Address - Fax:972-767-3532
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2023-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional