Doctor Name: | JUSTIN M WITT |
NPI Number: | 1265815062 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMSW |
License Number: | 001831 |
Business Practice Address: | 46 Albion St Bridgeport, CT - 066052602 |
Business Phone Number: | 2033306000 |
Business Fax Number: | 2033314716 |
Mailing Address: | 46 Albion St, BRIDGEPORT |
State: | CT |
Postal Code: | 066052602 |
Phone Number: | 2033306000 |
Fax Number: | 2033314716 |
NPI Enumeration Date: | 06/30/2015 |
NPI Last Update Date: | 06/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 001831 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |