Provider Demographics
NPI:1023821618
Name:HART, JASON BROWNE (ADC-IP)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:BROWNE
Last Name:HART
Suffix:
Gender:
Credentials:ADC-IP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3791
Mailing Address - Country:US
Mailing Address - Phone:864-318-8167
Mailing Address - Fax:
Practice Address - Street 1:1653 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3791
Practice Address - Country:US
Practice Address - Phone:864-318-8167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)