Active NPI
Jason Street, LPCA
- Professional Counselor
- Franklin, KY
National Provider Identifier
1699053512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1239
- Practice address
- 1031 Brookhaven Rd
Franklin, KY 42134-2743 - Phone
- (270) 901-5000
- Fax
- (270) 586-8828
- NPI assigned
- Jul 26, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1239 | KY | Primary |
Addresses
Primary practice location
1031 Brookhaven Rd
Franklin, KY 42134-2743
Mailing address
380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30604011 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1239 | KY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeskills, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Bowling Green, KY
- NPI 1669401816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1699053512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 SUWANNEE TRAIL ST",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421037956",
"telephone_number": "270-901-5000",
"fax_number": "270-842-5268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1031 BROOKHAVEN RD",
"city": "FRANKLIN",
"state": "KY",
"postal_code": "421342743",
"telephone_number": "270-901-5000",
"fax_number": "270-586-8828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STREET",
"first_name": "JASON",
"credential": "LPCA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-26",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "1239",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30604011",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Franklin, KY
- Stephen Lockard Snyder, M.D.
- Patrick Thomas Solomon, MA,, LPCA
- Spine Stop Franklin, PLLC
- Connie R Stclair, DMD
- Lori Beth Stevens, MS CCC-SLP
- Dwight Howell Sutton, M.D.
- Leigh Ann Taylor, PT
- The Medical Center at Franklin ER Physicians
- The Medical Center at Franklin Nutrition Therapy Program
- The Medical Center at Franklin, Inc. (Franklin Medical Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.