person
Jason Wayne Wyatt, LPCC
Professional Counselor in Las Cruces, New Mexico
NPI 1760780241

Jason Wayne Wyatt is a Professional Counselor based in Fairacres, NM and is specialized in Professional. Jason Wayne Wyatt practices in Las Cruces, NM and has the professional credentials of LPCC. The NPI Number for Jason Wayne Wyatt is 1760780241 and holds a License No. 0134631 (New Mexico).

The current practice location address for Jason Wayne Wyatt is 1705 N Valley Dr Ste 12, Las Cruces, NM and can be reached out via phone at 575-642-5544.

Location: 1705 N Valley Dr Ste 12, Las Cruces, NM, 88033-0375
person
Provider Profile Details
NPI Number
1760780241
Provider Name
Jason Wayne Wyatt
Credential
LPCC
Provider Entity Type
Individual
Gender
Male
Address
1705 N Valley Dr Ste 12, Las Cruces, NM, 88033-0375
Phone Number
575-642-5544
Fax Number
Provider Enumeration Date
03/07/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
18677037 05 NM
institution
Provider Business Practice Location Address Details
Address
1705 N Valley Dr Ste 12
City
State
Zip
88007-5121
Phone Number
575-642-5544
Fax Number
person
Provider Business Mailing Address Details
Address
1705 N Valley Dr Ste 12
City
State
Zip
88007-5121
Phone Number
575-642-5544
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
CCMH0175961 (New Mexico)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
0134631 (New Mexico)
Definition
Definition to come...
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