Provider Demographics
NPI:1982284279
Name:BLEHM, JASEN LEE (MSW)
Entity type:Individual
Prefix:
First Name:JASEN
Middle Name:LEE
Last Name:BLEHM
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 JENNINGS MILL RD UNIT 1700B
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7266
Mailing Address - Country:US
Mailing Address - Phone:470-355-5200
Mailing Address - Fax:
Practice Address - Street 1:1551 JENNINGS MILL RD UNIT 1700B
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7266
Practice Address - Country:US
Practice Address - Phone:470-355-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-11
Last Update Date:2021-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical