Provider Demographics
NPI:1902953912
Name:STRACK, JASON WILLIAM (LPC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:WILLIAM
Last Name:STRACK
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 1:501 BILTMORE AVE STE G276.10
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4601
Mailing Address - Country:US
Mailing Address - Phone:828-213-4502
Mailing Address - Fax:828-213-4540
Practice Address - Street 1:501 BILTMORE AVE STE G276.10
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4601
Practice Address - Country:US
Practice Address - Phone:828-213-4502
Practice Address - Fax:828-213-4540
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5149101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional