Provider Demographics
NPI:1215108451
Name:SEVAS, JASON R (LMFT)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:R
Last Name:SEVAS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WATERBURY RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-1250
Mailing Address - Country:US
Mailing Address - Phone:203-758-4958
Mailing Address - Fax:203-758-4957
Practice Address - Street 1:60 WATERBURY RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1250
Practice Address - Country:US
Practice Address - Phone:203-758-4958
Practice Address - Fax:203-758-4957
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-16
Last Update Date:2008-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000970106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist