Basic Information
| Provider Information | |||||||||
| NPI: | 1972961290 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STOFEL | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | KENT | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSW, LISW-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5665 HOOVER RD | ||||||||
| Address2: | |||||||||
| City: | GROVE CITY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431239122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148752371 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2440 DAWNLIGHT AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432111934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144168794 | ||||||||
| FaxNumber: | 6144783234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2016 | ||||||||
| LastUpdateDate: | 02/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I0009837 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.