Willoughby, Jason Cyril

Willoughby, Jason Cyril is an individual health care provider with primary practice located at 3401 Eudora St , Denver CO 80207-2500. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Willoughby, Jason Cyril can be contacted via phone (303) 300-6333.

Contact Information

Primary practice address
3401 Eudora St Denver CO 80207-2500
Phone: (303) 300-6333
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY.0003944 Colorado
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY.0003944 Colorado

Profile Details

NPI number 1811202443
LBN Legal business name Willoughby, Jason Cyril
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2010
Last updated Jul 7th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811202443 NPPES
Colorado MEDICAID 84281375

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