Provider Demographics
NPI:1811789068
Name:GRUZIN, JASON (LPC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:GRUZIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 FAIRVIEW RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2336
Mailing Address - Country:US
Mailing Address - Phone:856-809-2940
Mailing Address - Fax:856-336-2231
Practice Address - Street 1:630 FAIRVIEW RD STE 210
Practice Address - Street 2:
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-2336
Practice Address - Country:US
Practice Address - Phone:856-809-2940
Practice Address - Fax:856-336-2231
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional