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NPI Code Detail

MEDICARE: MR. JASON ANDREW WHITE

MEDICARE: MR. JASON ANDREW WHITE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YP2500XProfessional CounselorCP6036NV

General Provider Information

NPI Number : 1710236054
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON ANDREW WHITE
Provider Business Mailing Address
First Line : 2740 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-5398
Country : US
Telephone Number : 702-248-8866
Fax Number : 702-248-1339
Provider Business Practice Location Address
First Line : 2740 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-5398
Country : US
Telephone Number : 702-248-8866
Fax Number : 702-248-1339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2012
Last Update Date : 05/21/2025

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