Provider Demographics
NPI:1356425805
Name:CHESTER, JASON ANDREW (LMSW)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:ANDREW
Last Name:CHESTER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 THORMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SHELDON
Mailing Address - State:IA
Mailing Address - Zip Code:51201-2214
Mailing Address - Country:US
Mailing Address - Phone:712-225-2811
Mailing Address - Fax:712-225-2833
Practice Address - Street 1:215 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:IA
Practice Address - Zip Code:51012-1833
Practice Address - Country:US
Practice Address - Phone:712-225-2811
Practice Address - Fax:712-225-2833
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA029151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical