Provider Demographics
NPI:1578229423
Name:MOROSEY, JASON
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:MOROSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 THORNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1852
Mailing Address - Country:US
Mailing Address - Phone:716-969-6886
Mailing Address - Fax:
Practice Address - Street 1:21 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6501
Practice Address - Country:US
Practice Address - Phone:716-626-9016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011654101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health