Active NPI
Jason Fort, LPC
- Professional Counselor
- Bryan, TX
National Provider Identifier
1912559824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 77473
- Practice address
- 4103 S Texas Ave Ste 206
Bryan, TX 77802-4043 - Phone
- (979) 574-9933
- Fax
- (979) 202-0612
- NPI assigned
- Jul 10, 2019
- Last updated
- Dec 24, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | 77473 | TX | Primary |
Addresses
Primary practice location
4103 S Texas Ave Ste 206
Bryan, TX 77802-4043
Mailing address
PO Box 9408
College Station, TX 77842-9408
Phone (979) 318-2158
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 |
|---|---|---|---|
| 77473 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766534400000",
"number": "1912559824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9408",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778429408",
"telephone_number": "979-318-2158",
"fax_number": "979-202-0612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4103 S TEXAS AVE STE 206",
"city": "BRYAN",
"state": "TX",
"postal_code": "778024043",
"telephone_number": "979-574-9933",
"fax_number": "979-202-0612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORT",
"first_name": "JASON",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-10",
"last_updated": "2025-12-24",
"certification_date": "2025-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "77473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.