Jason Forrest Mathers, PH.D., LPC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2006036655 Issued in MO

Practice address

119 Clarkson Executive Park
Ellisville, MO 63011-2176

Phone

(636) 256-0600

Fax

(636) 256-0626

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1205914173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CLARKSON EXECUTIVE PARK",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112176",
            "telephone_number": "636-256-0600",
            "fax_number": "636-256-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CLARKSON EXECUTIVE PARK",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112176",
            "telephone_number": "636-256-0600",
            "fax_number": "636-256-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHERS",
        "first_name": "JASON",
        "middle_name": "FORREST",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2001014823",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2006036655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giovanna Mancuso
• Matthew John Markelz, ATC
• Jeffrey L Marlow, R.PH.
• Crystal Martin, D.D.S.
• Tammy L. Martin, M.D.
• Anna T McCarthy, M.S., CCC-SLP
• Joan M McCourt, ANP
• James Austin McDaniel III, D.C.
• Wendy Ann McDougal, M.A.
• Meredith McGaughey, COTA/L

• Psychologist in Ellisville, MO
• Providers in Ellisville, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.