Provider Demographics
NPI:1043795958
Name:ANDREWS, JASON M (LPC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:M
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-1513
Mailing Address - Country:US
Mailing Address - Phone:501-666-8686
Mailing Address - Fax:
Practice Address - Street 1:3395 HIGHWAY 5 N STE 300
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72019-9031
Practice Address - Country:US
Practice Address - Phone:501-508-2600
Practice Address - Fax:501-708-2185
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2006028101YP2500X
ARA1807084101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor