Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jasper M Boomer, LSATP

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1679227623

Jasper M Boomer, LSATP is an Addiction (Substance Use Disorder) Counselor in Chantilly, Virginia. Licensed in Virginia. Registered with an NPI since 2022.

Licensed in
VA
In the registry since
2022

Practice location Address checks out

4229 Lafayette Ctr Dr Ste 1675
Chantilly, VA 20151-1270
Phone: (855) 326-4673
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 0718000456 (VA)

Record details

NPI number1679227623
Entity typeIndividual (Type 1)
GenderMale
Credentials LSATP
Sole proprietorNo
NPI enumeratedFebruary 8, 2022
Last updated in NPPESFebruary 8, 2022
Certification dateFebruary 8, 2022

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