Provider Demographics
NPI:1548401185
Name:THOMAS, JASON EUGENE (LCSW, CADC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:EUGENE
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 BROOKWATER LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-6036
Mailing Address - Country:US
Mailing Address - Phone:859-327-1042
Mailing Address - Fax:
Practice Address - Street 1:1393 TRENT BOULEVARD
Practice Address - Street 2:BUILDING 2, SUITE 2101
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517
Practice Address - Country:US
Practice Address - Phone:859-233-0033
Practice Address - Fax:859-233-1269
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1017101YA0400X
KY3285104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)