Healthcare Provider Details

I. General information

NPI: 1295814358
Provider Name (Legal Business Name): ANGIE DEE HOLTON WITMAN MA, LCP, LCMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 W HWY 24
GOODLAND KS
67735-9615
US

IV. Provider business mailing address

1018 ARCADE AVE
GOODLAND KS
67735-3424
US

V. Phone/Fax

Practice location:
  • Phone: 785-899-4135
  • Fax: 785-899-6303
Mailing address:
  • Phone: 785-899-4135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number910
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number699
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: