Provider Demographics
NPI:1790099935
Name:CONE, JASON CARTER (LPA)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:CARTER
Last Name:CONE
Suffix:
Gender:M
Credentials:LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 DUNHAGAN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-6640
Mailing Address - Country:US
Mailing Address - Phone:252-751-0518
Mailing Address - Fax:252-565-4505
Practice Address - Street 1:3851 DUNHAGAN RD STE 102
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858
Practice Address - Country:US
Practice Address - Phone:252-751-0518
Practice Address - Fax:252-565-4505
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3913101YP2500X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional