Provider Demographics
NPI:1568909059
Name:HEWITT, JASON (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HEWITT
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3207 CAPSICUM CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2605
Mailing Address - Country:US
Mailing Address - Phone:512-656-9877
Mailing Address - Fax:
Practice Address - Street 1:3207 CAPSICUM CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-2605
Practice Address - Country:US
Practice Address - Phone:512-656-9877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-23
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202174106H00000X
TX71657101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist