Healthcare Provider Details

I. General information

NPI: 1710009188
Provider Name (Legal Business Name): STEVE MCNITT LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 PLACERVILLE DR STE 17
PLACERVILLE CA
95667-3972
US

IV. Provider business mailing address

344 PLACERVILLE DR STE 17
PLACERVILLE CA
95667-3972
US

V. Phone/Fax

Practice location:
  • Phone: 530-621-6344
  • Fax:
Mailing address:
  • Phone: 530-621-6344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS17618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: