Tanner, Jason Matthew

Tanner, Jason Matthew is an individual health care provider with primary practice located at 372 S Greeno Rd , Fairhope AL 36532-1916. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Tanner, Jason Matthew can be contacted via phone (251) 990-4243.

Contact Information

Primary practice address
372 S Greeno Rd Fairhope AL 36532-1916
Phone: (251) 990-4243
Fax: (251) 928-0126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 0873C Alabama

Profile Details

NPI number 1255588166
LBN Legal business name Tanner, Jason Matthew
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2008
Last updated Aug 21st, 2008 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1255588166 NPPES
Alabama Other 051530538 BLUE CROSS/ BLUE SHIELD

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