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NPI Code Detail

MEDICARE: DAVID MICHAEL WITTKOPF LCDC, LPC-A

MEDICARE: DAVID MICHAEL WITTKOPF LCDC, LPC-A
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
1101YM0800XMental Health Counselor93724TX
2101YA0400XAddiction (Substance Use Disorder) Counselor16802TX

General Provider Information

NPI Number : 1740099621
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID MICHAEL WITTKOPF LCDC, LPC-A
Provider Business Mailing Address
First Line : 309 CARVER ST
Second Line :
City : MCKINNEY
State : TX
Zip : 75069-4246
Country : US
Telephone Number : 903-303-7210
Fax Number :
Provider Business Practice Location Address
First Line : 5710 LYNDON B JOHNSON FWY STE 165
Second Line :
City : DALLAS
State : TX
Zip : 75240-6572
Country : US
Telephone Number : 972-970-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2025
Last Update Date : 01/06/2025

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