Provider Demographics
NPI:1649753633
Name:YORK, JASON ANDREW (LPC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ANDREW
Last Name:YORK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 MONTEREY OAKS BLVD APT 833
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-0904
Mailing Address - Country:US
Mailing Address - Phone:254-717-3848
Mailing Address - Fax:
Practice Address - Street 1:4701 MONTEREY OAKS BLVD APT 833
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-0904
Practice Address - Country:US
Practice Address - Phone:254-717-3848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69853101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional