Provider Demographics
NPI:1659423804
Name:TOMPKINS, JASON ANDREW (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:ANDREW
Last Name:TOMPKINS
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Gender:M
Credentials:LCSW
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Mailing Address - Street 1:10800 BRIGHTON BAY BLVD NE
Mailing Address - Street 2:15105
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3478
Mailing Address - Country:US
Mailing Address - Phone:813-784-0153
Mailing Address - Fax:727-563-9435
Practice Address - Street 1:806 W DE LEON ST
Practice Address - Street 2:203
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2731
Practice Address - Country:US
Practice Address - Phone:813-784-0153
Practice Address - Fax:727-563-9435
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL83861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical