Provider Demographics
NPI:1386044592
Name:JASON A. TOMPKINS, LCSW
Entity Type:Organization
Organization Name:JASON A. TOMPKINS, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-784-0153
Mailing Address - Street 1:806 W DE LEON ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-2731
Mailing Address - Country:US
Mailing Address - Phone:813-784-0153
Mailing Address - Fax:
Practice Address - Street 1:806 W DE LEON ST
Practice Address - Street 2:SUITE 203
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2731
Practice Address - Country:US
Practice Address - Phone:813-784-0153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW83861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty