Provider Demographics
NPI:1952665762
Name:HOOPER, JASON (MSW)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:HOOPER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 NW 11TH ST STE W203
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-4350
Mailing Address - Country:US
Mailing Address - Phone:786-481-5909
Mailing Address - Fax:786-481-5908
Practice Address - Street 1:151 NW 11TH ST STE W203
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4350
Practice Address - Country:US
Practice Address - Phone:786-481-5909
Practice Address - Fax:786-481-5908
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker