Shane Matthew Witzki

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2020024396 Issued in MO

Practice address

110 Westwoods Dr
Liberty, MO 64068-1181

Phone

(816) 368-1889

NPI assigned

Aug 22, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Stacy Witzki Consulting, LLC

  • Counselor
  • Liberty, MO
  • NPI 1073250221
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1053039461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 SHANNON DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640682892",
            "telephone_number": "816-547-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WESTWOODS DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681181",
            "telephone_number": "816-368-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITZKI",
        "first_name": "SHANE",
        "middle_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2020024396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Wingerson, RBT
• Katelynn Wininger, RBT
• Winterpast Associates, LLC
• Lauren Witherspoon
• Pamela Ann Wittmeyer, RDH
• Stacy Witzki
• Autumn Elizabeth Woods
• Jaclyn Woods
• Luke David Wordekemper, DDS
• Olivia Joy Wrisinger

• Professional Counselor in Liberty, MO
• Providers in Liberty, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.