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Jason L. Fairweather
Professional Counselor in Berlin, Wisconsin
NPI 1225626963

Jason L. Fairweather is a Professional Counselor based in Berlin, WI and is specialized in Professional. Jason L. Fairweather practices in Berlin, WI. The NPI Number for Jason L. Fairweather is 1225626963 and holds a License No. (Wisconsin).

The current practice location address for Jason L. Fairweather is 553 Broadway, Berlin, WI and can be reached out via phone at 920-204-6590.

Location: 553 Broadway, Berlin, WI, 54923-1323
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1225626963
Provider Name
Jason L. Fairweather
Credential
Provider Entity Type
Organization
Address
553 Broadway, Berlin, WI, 54923-1323
Phone Number
920-204-6590
Fax Number
Provider Enumeration Date
01/07/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
553 Broadway
City
Berlin
State
Wisconsin
Zip
54923-1323
Phone Number
920-204-6590
Fax Number
person
Provider Business Mailing Address Details
Address
553 Broadway
City
Berlin
State
Wisconsin
Zip
54923-1323
Phone Number
920-204-6590
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
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