| Doctor Name: | MR. JASON KESSINGER |
| NPI Number: | 1598939928 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.C.S.W. |
| License Number: | LCSW-26572 |
| Business Practice Address: | 205 107th St Orofino, ID - 835449381 |
| Business Phone Number: | 2084767483 |
| Business Fax Number: | 2084763144 |
| Mailing Address: | 205 107th St, OROFINO |
| State: | ID |
| Postal Code: | 835449381 |
| Phone Number: | 2084767483 |
| Fax Number: | 2084763144 |
| NPI Enumeration Date: | 04/16/2008 |
| NPI Last Update Date: | 04/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LCSW-26572 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |