MEDICARE: JASON WAYNE WYATT LPCC

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
1	101YM0800X	Mental Health Counselor	0134631	NM
2	101YP2500X	Professional Counselor	CCMH0175961	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760780241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON WAYNE WYATT LPCC

Provider Business Mailing Address
First Line	:	PO BOX 375
Second Line	:
City	:	FAIRACRES
State	:	NM
Zip	:	88033-0375
Country	:	US
Telephone Number	:	575-642-5544
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 N VALLEY DR STE 12
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-5121
Country	:	US
Telephone Number	:	575-642-5544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2011
Last Update Date	:	09/07/2021

Similar Medicare Providers

1083715130 — DR. LAURA RODRIGUEZ D.C
Practice Location Address:

1705 NORTH VALLEY DRIVE , SUITE 4
LAS CRUCES, NM
88007-5121

Practice Phone: 575-527-5083
Practice Fax: 575-527-5093

1679753768 — MS. LAURA ANNE BULLOCK LMT
Practice Location Address:

1705 N VALLEY DR , SUITE 2
LAS CRUCES, NM
88007-5121

Practice Phone: 575-650-6113
Practice Fax:

1235399668 — RODRIGUEZ FAMILY CHIROPRACTIC INC.
Practice Location Address:

1705 N VALLEY DR , SUITE 4
LAS CRUCES, NM
88007-5121

Practice Phone: 575-527-5083
Practice Fax: 575-527-5093

1336718287 — JASON WYATT, LPCC, LLC
Practice Location Address:

1705 N VALLEY DR STE 12
LAS CRUCES, NM
88007-5121

Practice Phone: 575-642-5544
Practice Fax:

1770327348 — CARE FINANCIAL LLC
Practice Location Address:

1705 N VALLEY DR STE 13
LAS CRUCES, NM
88007-5121

Practice Phone: 575-621-5811
Practice Fax: 505-312-6032

1316206758 — MS. JENNY LYN L LEDESMA LMFT
Practice Location Address:

3465 W CRAIG RD STE D
NORTH LAS VEGAS, NV
89032-5121

Practice Phone: 702-300-5128
Practice Fax:

Directions to “ JASON WAYNE WYATT LPCC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.