Provider Demographics
NPI:1578129680
Name:GREVE, JASON R (MA, LPC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:R
Last Name:GREVE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 EASTMAN AVE STE 241
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6797
Mailing Address - Country:US
Mailing Address - Phone:989-423-0179
Mailing Address - Fax:989-488-6141
Practice Address - Street 1:5103 EASTMAN AVE STE 241
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6797
Practice Address - Country:US
Practice Address - Phone:989-423-0179
Practice Address - Fax:989-488-6141
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222525101YM0800X
MI6401017141101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health