Jeanne Patricia Witter, PHD, LPC, LISAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-12942 Issued in AZ

Practice address

17505 N 79TH Ave
Suite 410D
Glendale, AZ 85308-8725

Phone

(623) 340-1020

NPI assigned

May 28, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1487091682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13839 N DRIFTWOOD PT",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853512309",
            "telephone_number": "623-340-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17505 N 79TH AVE",
            "address_2": "SUITE 410D",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088725",
            "telephone_number": "623-340-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTER",
        "first_name": "JEANNE",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, LISAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-11849",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-12942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.

Verify at the official NPI Registry.