Provider Demographics
NPI:1154794279
Name:WINKLER, JASON (MA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:WINKLER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3756
Mailing Address - Country:US
Mailing Address - Phone:704-957-3310
Mailing Address - Fax:
Practice Address - Street 1:32 N MAIN ST
Practice Address - Street 2:SUITE 214
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3162
Practice Address - Country:US
Practice Address - Phone:704-825-9696
Practice Address - Fax:866-880-8347
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21090101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)