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Organization
JASON L. FAIRWEATHER
Active
Organization
JASON L. FAIRWEATHER
Active
Other names
Walk of Life Counseling, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JASON LEE FAIRWEATHER LPCIT, SACIT (OWNER)
(920) 204-6590
Entity
Organization
Contact information
Practice address
553 BROADWAY, BERLIN, WI 54923-1323
(920) 204-6590
Mailing address
553 BROADWAY, BERLIN, WI 54923-1323
(920) 204-6590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/07/2021
Last updated
01/12/2021
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