Organization
JET, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON MICHAEL THAYER LCSW (PRESIDENT)
(606) 271-1920
Entity
Organization
Contact information
Practice address
149 ENTERPRISE DR, SOMERSET, KY 42501-6155
(606) 679-6995
(606) 451-9465
Mailing address
312 RANDOLPH ST, SOMERSET, KY 42501-1165
(606) 271-1920
(606) 451-9465
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCSW 3155
KY
Other
Enumeration date
02/07/2013
Last updated
02/07/2013
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