Jason W Waller, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.2305477 Issued in OH

Practice address

3127 Quinby Dr
Columbus, OH 43232-7734

Phone

(765) 586-6894

NPI assigned

Sep 14, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Achieve Psychological and Academic Services LLC

  • School Psychologist
  • Powell, OH
  • NPI 1780286179
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1093592719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 QUINBY DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432327734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3127 QUINBY DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432327734",
            "telephone_number": "765-586-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "JASON",
        "middle_name": "W",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2305477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyson Waller, PHARMD
• Brittain Waller, MD
• Cheryl Ann Waller, MS,RD,LD
• Cynthia Waller
• Donna M Waller, C-TRNE
• Kristin Nichole Waller, CDCA
• Timothy D Waller
• Megan J. Walley, M.D.
• Faith Hannah Wallick
• Rebecca Wallihan, MD

• Mental Health Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.