Provider Demographics
NPI:1821539552
Name:KAUFMAN, JASON (LMFT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2763
Mailing Address - Country:US
Mailing Address - Phone:161-746-1838
Mailing Address - Fax:781-559-3096
Practice Address - Street 1:41 GARRISON RD
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-4445
Practice Address - Country:US
Practice Address - Phone:617-277-8107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1766106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist