Organization · Type 2 NPI

Jason Wyatt, Lpcc, LLC

Mental Health Clinic/Center (Including Community Mental Health Center) · Las Cruces, NM

NPI number 1336718287 Active

Practice location

1705 N Valley Dr Ste 12
Las Cruces, NM 88007-5121

Call (575) 642-5544 Map

Mailing address

PO Box 375
Fairacres, NM 88033-0375

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	None listed

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

Another provider at this address

Jason Wayne Wyatt, LPCCProfessional Counselor Las Cruces, NM NPI 1760780241

Other mental health clinic/center (including community mental health center) providers in Las Cruces

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NPI record

NPI: 1336718287
Entity type: Organization (Type 2)
Issued: Jun 23, 2021
Last updated: Sep 7, 2021
Status: Active

Other names

<unavail>
Excelsior Mental Health Services · doing business as
Excelsior Mental Health Services · doing business as

Authorized official

Jason Wyatt
Owner/therapist
(575) 642-5544

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1336718287

Jason Wyatt, Lpcc, LLC's National Provider Identifier is 1336718287, issued on Jun 23, 2021. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Las Cruces, NM. The record was last updated on Sep 7, 2021.