Individual
MR. JASON EDWARD CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPCC-S, LICDC
Contact information
Practice address
422 W LOVELAND AVE, LOVELAND, OH 45140-2322
(513) 334-7272
(513) 676-0051
Mailing address
422 W LOVELAND AVE, LOVELAND, OH 45140-2322
(513) 334-7272
(513) 676-0051
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162169
OH
101YM0800X
Mental Health Counselor
39004679A
IN
101YM0800X
Mental Health Counselor
Primary
E.2202902-SUPV
OH
101YP2500X
Professional Counselor
E.2202902-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0479064
—
OH
05
—
300084117
—
IN
01
—
6185268
AETNA PROVIDER NUMBER
—
01
—
CS2223800174
CARESOURCE PROVIDER NUMBER
—
Enumeration date
03/17/2020
Last updated
03/22/2024
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