Individual
MR. JASON RAY PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC, NCC
Contact information
Practice address
1506 W HOVEY ST, SPRINGFIELD, MO 65802-1511
(417) 827-6547
Mailing address
1506 W HOVEY ST, SPRINGFIELD, MO 65802-1511
(417) 827-6547
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6482
MO
101YM0800X
Mental Health Counselor
Primary
2015031521
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2015031521
—
MO
Enumeration date
08/28/2013
Last updated
03/17/2018
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