Jason Deford, LCPC

NPI #1083169965 in Peoria, Illinois

Provider Information

NPI Number: 1083169965
Entity Type: Individual
Name: Jason Deford, LCPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: LCPC
Enumeration Date: Aug 19, 2016
Last Updated: Aug 19, 2016

Practice Location

Address: 3020 W WILLOW KNOLLS DR
City: Peoria
State: Illinois
ZIP Code: 61614-8127
Phone: (309) 681-5652

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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