Healthcare Provider Details

I. General information

NPI: 1114237112
Provider Name (Legal Business Name): JULIA F VITMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2010
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 ROGER BROOKE DR
FORT SAM HOUSTON TX
78234-4504
US

IV. Provider business mailing address

10631 OPEN RANGE CT
LAS VEGAS NV
89179-1808
US

V. Phone/Fax

Practice location:
  • Phone: 210-916-9588
  • Fax:
Mailing address:
  • Phone: 702-592-0557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7563-C
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: