Fairweather, Jason Lee

Fairweather, Jason Lee is an sole proprietor health care provider with primary practice located at 553 Broadway , Berlin WI 54923-1323. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Fairweather, Jason Lee can be contacted via phone (920) 204-6590.

Contact Information

Primary practice address
553 Broadway Berlin WI 54923-1323
Phone: (920) 204-6590
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 10532-125 Wisconsin

Profile Details

NPI number 1689278590
LBN Legal business name Fairweather, Jason Lee
Credentials LPC, SACIT, CSIT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 23rd, 2020
Last updated Sep 26th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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