Provider Demographics
NPI:1639443625
Name:BIEN, JASON (LPC, MAMFC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:BIEN
Suffix:
Gender:M
Credentials:LPC, MAMFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 HILLSIDE DR W
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-3204
Mailing Address - Country:US
Mailing Address - Phone:817-253-5534
Mailing Address - Fax:
Practice Address - Street 1:1401 LOOP 323 W SW
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701
Practice Address - Country:US
Practice Address - Phone:817-253-5534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65281101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional