Provider Demographics
NPI:1427911460
Name:ALBON, JASON
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:ALBON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E CAROLINE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:PA
Mailing Address - Zip Code:17970-1302
Mailing Address - Country:US
Mailing Address - Phone:570-622-2216
Mailing Address - Fax:
Practice Address - Street 1:401 W MARKET ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-2930
Practice Address - Country:US
Practice Address - Phone:570-622-2216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012105101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty