Provider Demographics
NPI:1124433537
Name:GEARHEART, JASON (LPC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:GEARHEART
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08629-1447
Mailing Address - Country:US
Mailing Address - Phone:609-424-8722
Mailing Address - Fax:
Practice Address - Street 1:1456 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08629-1447
Practice Address - Country:US
Practice Address - Phone:609-424-8722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00284300101YA0400X
NJ37PC01043400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)