MEDICARE: SHANA WITKIN LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	089.0091875	VT

General Provider Information

NPI Number	:	1356886105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANA WITKIN LICSW

Provider Business Mailing Address
First Line	:	358 CEMETERY RD
Second Line	:
City	:	RICHMOND
State	:	VT
Zip	:	05477-9444
Country	:	US
Telephone Number	:	802-662-0126
Fax Number	:

Provider Business Practice Location Address
First Line	:	358 CEMETERY RD
Second Line	:
City	:	RICHMOND
State	:	VT
Zip	:	05477-9444
Country	:	US
Telephone Number	:	802-662-0126
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2017
Last Update Date	:	03/18/2026

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Directions to “ SHANA WITKIN LICSW” Practice Location

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