Provider Demographics
NPI:1710496161
Name:BURKHEAD, JASON (LPC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:BURKHEAD
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 1:8389 MARC GREGORY CT
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2467
Mailing Address - Country:US
Mailing Address - Phone:804-569-5145
Mailing Address - Fax:
Practice Address - Street 1:8389 MARC GREGORY CT
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2467
Practice Address - Country:US
Practice Address - Phone:804-569-5145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health