Mildred Mary Witt, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3959 Issued in NC

Practice address

104 Crane Meadow PL
Chapel Hill, NC 27514-6859

Phone

(919) 317-2900

NPI assigned

Mar 29, 2011

Last updated

Mar 29, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Senior Life Management, P.L.L.C.

  • Clinical Psychologist
  • Carle Place, NY
  • NPI 1396799557
  NPD (past)

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1093004293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CRANE MEADOW PL",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275146859",
            "telephone_number": "919-402-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CRANE MEADOW PL",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275146859",
            "telephone_number": "919-317-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "MILDRED",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10521964",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Helene Wise, PH.D.
• Peyton Wisniewski
• Deasia Syteena Witherspoon, MD
• Glenn Ashley Withrow, M.D.
• Caitlin Elise Witt, MD
• Philip L Witt
• Jason Adam Wittes, PHARMD
• Virginia Reed Wittig, PMHCNS-BC
• Russell Wnek
• Sara Elizabeth Wobker, MD

• Clinical Psychologist in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.