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Individual

MR. JASON THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCDC III

Contact information

Practice address
3121 W BROAD ST, COLUMBUS, OH 43204-1306
(614) 869-2002
Mailing address
76 S POWELL AVE, COLUMBUS, OH 43204-3030
(507) 513-8340

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
182633
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.162716
OH

Other

Enumeration date
12/26/2022
Last updated
06/28/2024
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