Individual
JASON NORTHRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., LMFT-S
Contact information
Practice address
21015 MARKET RIDGE, STE. 101, SAN ANTONIO, TX 78258-4979
(210) 496-0100
(210) 496-0101
Mailing address
21015 MARKET RIDGE, STE. 101, SAN ANTONIO, TX 78258-4979
(210) 833-4011
(210) 496-0101
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
200911
TX
101YP2500X
Professional Counselor
62058
TX
106H00000X
Marriage & Family Therapist
200911
TX
Other
Enumeration date
08/12/2008
Last updated
08/31/2021
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