Individual provider · Type 1 NPI

Jason Deford, LCPC

Mental Health Counselor · Peoria, IL

NPI number 1083169965 Active

Practice location

3020 W Willow Knolls Dr
Peoria, IL 61614-8127

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X180010119 (IL)

Mental Health Counselor: Definition to come...

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About NPI 1083169965

Jason Deford, LCPC's National Provider Identifier is 1083169965, issued on Aug 19, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Peoria, IL. The record was last updated on Aug 19, 2016.