Active NPI
Eric Thomas Wittenberg, MSW LICSW
- Clinical Social Worker
- Duluth, MN
National Provider Identifier
1326241100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18839
- Practice address
- 1924 E 1St St
Duluth, MN 55812-1764 - Phone
- (218) 260-8340
- NPI assigned
- Jun 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18839 | MN | Primary |
Addresses
Primary practice location
1924 E 1St St
Duluth, MN 55812-1764
Mailing address
1924 E 1St St
Duluth, MN 55812-1764
Phone (218) 260-8340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18839 | MN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368144000000",
"number": "1326241100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1924 E 1ST ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558121764",
"telephone_number": "218-260-8340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1924 E 1ST ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558121764",
"telephone_number": "218-260-8340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTENBERG",
"first_name": "ERIC",
"middle_name": "THOMAS",
"credential": "MSW LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-07",
"last_updated": "2013-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "18839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.