Individual
JASON R SMALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCA
Contact information
Practice address
300 FOXGLOVE DR, MOUNT STERLING, KY 40353-9769
(866) 233-1955
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(063) 298-5886
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
103119
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30615058
—
KY
Enumeration date
02/08/2007
Last updated
06/17/2024
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