Provider Demographics
NPI:1316712649
Name:BRAZIER, JASON (LCPT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:BRAZIER
Suffix:
Gender:M
Credentials:LCPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 THUELER ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-2141
Mailing Address - Country:US
Mailing Address - Phone:423-322-7444
Mailing Address - Fax:
Practice Address - Street 1:6816 TY HI DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1456
Practice Address - Country:US
Practice Address - Phone:423-499-9535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN67101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral