Jason Poblacion

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401016154 Issued in MI

Practice address

1370 N Oakland Blvd Ste 105
Waterford, MI 48327-1572

Phone

(248) 666-8870

NPI assigned

Jul 5, 2017

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

State licenses

Practice roles

Locations

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.

• Catholic Charities of Southeast Michigan

  • Clinical Social Worker
  • Madison Heights, MI
  • NPI 1316283757

  Professional

  NPD

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619498235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 N OAKLAND BLVD STE 105",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271572",
            "telephone_number": "248-666-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 N OAKLAND BLVD STE 105",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271572",
            "telephone_number": "248-666-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POBLACION",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401016154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Pittaway, PROVIDER
• Courtney Aunyell Pittman
• Plaine Physical Therapy, LLC
• Sara Lori Platz, LLMSW
• William Ernest Plemons, PTA
• Glenn B Pollock, DMD
• Katherine Alycia Polmear, LLPC
• Bonita Pomeroy, LLPC
• Lori Popa, RN
• Brenda J Pope, RN, MSN, FNP-BC

• Professional Counselor in Waterford, MI
• Providers in Waterford, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.