Provider Demographics
NPI:1285399675
Name:EICHER, JASON LYNN (LPC)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:LYNN
Last Name:EICHER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:JASON
Other - Middle Name:LYNN
Other - Last Name:EICHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3925 GROVE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:GAMBIER
Mailing Address - State:OH
Mailing Address - Zip Code:43022-9734
Mailing Address - Country:US
Mailing Address - Phone:330-231-4668
Mailing Address - Fax:
Practice Address - Street 1:111 S MULBERRY ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-3307
Practice Address - Country:US
Practice Address - Phone:740-393-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2103802101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional