Provider Demographics
NPI:1417507872
Name:JASON SMITH ASSESSMENT AND COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:JASON SMITH ASSESSMENT AND COUNSELING ASSOCIATES
Other - Org Name:ASSESSMENT & COUNSELING ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:W
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:515-419-1742
Mailing Address - Street 1:950 OFFICE PARK RD STE 235
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2121
Mailing Address - Country:US
Mailing Address - Phone:515-419-1742
Mailing Address - Fax:
Practice Address - Street 1:950 OFFICE PARK RD STE 235
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2121
Practice Address - Country:US
Practice Address - Phone:515-419-1742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-18
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health