Provider Demographics
NPI:1982788139
Name:RIBBING, JASON JOHN (MS LPC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:JOHN
Last Name:RIBBING
Suffix:
Gender:M
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 AMITY RD
Mailing Address - Street 2:STE 605
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5964
Mailing Address - Country:US
Mailing Address - Phone:501-205-0253
Mailing Address - Fax:501-205-0253
Practice Address - Street 1:8 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:MORRILTON
Practice Address - State:AR
Practice Address - Zip Code:72110
Practice Address - Country:US
Practice Address - Phone:501-354-1561
Practice Address - Fax:501-354-1564
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0707034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional