Provider Demographics
NPI:1366335531
Name:WITTE, JASON LEE (EDS)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:LEE
Last Name:WITTE
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2975
Mailing Address - Country:US
Mailing Address - Phone:531-299-1320
Mailing Address - Fax:
Practice Address - Street 1:4020 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2975
Practice Address - Country:US
Practice Address - Phone:531-299-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist