Provider Demographics
NPI:1902165483
Name:IGNAUT, JASON (LPCC)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:IGNAUT
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8227 BRECKSVILLE RD
Mailing Address - Street 2:#104
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1370
Mailing Address - Country:US
Mailing Address - Phone:440-526-0468
Mailing Address - Fax:440-526-0454
Practice Address - Street 1:8227 BRECKSVILLE RD
Practice Address - Street 2:#104
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1370
Practice Address - Country:US
Practice Address - Phone:440-526-0468
Practice Address - Fax:440-526-0454
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0008348101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE0008348OtherLICENSE