| Doctor Name: | JASON CHRISTIAN LOOTENS |
| NPI Number: | 1396161170 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMSW |
| License Number: | 6801091169 |
| Business Practice Address: | East Highway 18 Ihs Compound Pine Ridge, SD - 577701201 |
| Business Phone Number: | 6058673091 |
| Business Fax Number: | 6058673268 |
| Mailing Address: | Po Box 1201, PINE RIDGE |
| State: | SD |
| Postal Code: | 577701201 |
| Phone Number: | 6058673091 |
| Fax Number: | 6058673268 |
| NPI Enumeration Date: | 03/17/2014 |
| NPI Last Update Date: | 03/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6801091169 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |