Individual provider · Type 1 NPI

Jasper M. Boomer, LSATP

Addiction (Substance Use Disorder) Counselor · Chantilly, VA

NPI number 1679227623 Active

Practice location

4229 Lafayette Ctr Dr Ste 1675
Chantilly, VA 20151-1270

Call (855) 326-4673 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X0718000456 (VA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1679227623

Jasper M. Boomer, LSATP's National Provider Identifier is 1679227623, issued on Feb 8, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Chantilly, VA. The record was last updated on Feb 8, 2022.