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NPI Code Detail

MEDICARE: ANDREA WITTER LCSW

MEDICARE:   ANDREA  WITTER  LCSW
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
11041C0700XClinical Social Worker093827NY

General Provider Information

NPI Number : 1912477811
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA WITTER LCSW
Provider Business Mailing Address
First Line : 2980 PLANK RD
Second Line :
City : LIMA
State : NY
Zip : 14485-9556
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2510 CHILI AVE STE 5
Second Line :
City : ROCHESTER
State : NY
Zip : 14624-3334
Country : US
Telephone Number : 585-406-3151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2018
Last Update Date : 05/09/2023

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Directions to “ ANDREA WITTER LCSW” Practice Location

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