Provider Demographics
NPI:1700590205
Name:JASION, ALEXANDER ARTHUR (LGPC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:ARTHUR
Last Name:JASION
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9475 DEERECO RD STE 410
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2124
Mailing Address - Country:US
Mailing Address - Phone:443-632-7102
Mailing Address - Fax:410-560-6136
Practice Address - Street 1:9475 DEERECO RD STE 410
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2124
Practice Address - Country:US
Practice Address - Phone:443-632-7102
Practice Address - Fax:410-560-6136
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11299101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health