Provider Demographics
NPI:1508135583
Name:ADKINS, JASON (LCSW)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:ADKINS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14080 VOYAGE TRL
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-0616
Mailing Address - Country:US
Mailing Address - Phone:678-499-8424
Mailing Address - Fax:
Practice Address - Street 1:550 W SPERRY STREET
Practice Address - Street 2:PO BOX 469
Practice Address - City:HEPPNER
Practice Address - State:OR
Practice Address - Zip Code:97836
Practice Address - Country:US
Practice Address - Phone:541-676-9161
Practice Address - Fax:541-676-5662
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL15503101YM0800X
GACSW0046611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical