Individual
JASON MATTHEW PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MH COUNSELOR INTERN
Contact information
Practice address
41315 N RIDGE RD, ELYRIA, OH 44035-1242
(440) 366-1106
(440) 366-7632
Mailing address
PO BOX 72767, CLEVELAND, OH 44192-0004
(800) 860-7373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.2305059-TRNE
OH
101YM0800X
Mental Health Counselor
Primary
C.2406590
OH
Other
Enumeration date
11/21/2023
Last updated
04/16/2026
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