Provider Demographics
NPI:1477211522
Name:HORODYSKI, JASON R (MA, LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:R
Last Name:HORODYSKI
Suffix:
Gender:M
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15475 ANDREWS DR UNIT 207
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-5791
Mailing Address - Country:US
Mailing Address - Phone:303-917-4945
Mailing Address - Fax:
Practice Address - Street 1:15475 ANDREWS DR UNIT 207
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-5791
Practice Address - Country:US
Practice Address - Phone:303-917-4945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional