Provider Demographics
NPI:1588406854
Name:NAYLOR, JASON W (LMFT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:W
Last Name:NAYLOR
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:PO BOX 802
Mailing Address - Street 2:
Mailing Address - City:WEST DOVER
Mailing Address - State:VT
Mailing Address - Zip Code:05356-0802
Mailing Address - Country:US
Mailing Address - Phone:860-227-5459
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 802
Practice Address - Street 2:
Practice Address - City:WEST DOVER
Practice Address - State:VT
Practice Address - Zip Code:05356-0802
Practice Address - Country:US
Practice Address - Phone:860-227-5459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-08
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT783106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist