Individual provider Active NPI

Jason Blaise Gans

  • Professional Counselor
  • Austin, TX
National Provider Identifier
1972217826
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
76153 Issued in TX
Practice address
11402 Joy St
Austin, TX 78748-2752
Phone
(512) 808-8440
NPI assigned
Jan 5, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 76153 TX Primary

Addresses

Primary practice location

11402 Joy St
Austin, TX 78748-2752

Mailing address

1120 Richardine Ave
Austin, TX 78721-2632
Phone (512) 808-8440

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

LicenseStateTypeSpecialty
76153TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1672876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1972217826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 RICHARDINE AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787212632",
            "telephone_number": "512-808-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11402 JOY ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482752",
            "telephone_number": "512-808-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANS",
        "first_name": "JASON",
        "middle_name": "BLAISE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-05",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "76153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.