Provider Demographics
NPI:1922398999
Name:DOORISH, JASON JOHN (LPC-S)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:JOHN
Last Name:DOORISH
Suffix:
Gender:M
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 N LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2954
Mailing Address - Country:US
Mailing Address - Phone:940-597-3469
Mailing Address - Fax:
Practice Address - Street 1:920 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2954
Practice Address - Country:US
Practice Address - Phone:940-597-3469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64610101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional