Mary Dewitt, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS18301 Issued in CA

Practice address

208 Providence Mine Rd Ste 122
Nevada City, CA 95959-2955

Phone

(530) 470-0299

NPI assigned

Aug 31, 2016

Last updated

Aug 31, 2016By 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)

Enrolled

State licenses

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1548716368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 PROVIDENCE MINE ROAD, SUITE 122",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "95959",
            "telephone_number": "530-470-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 PROVIDENCE MINE RD STE 122",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592955",
            "telephone_number": "530-470-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS18301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "13778436",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Decosse, DC
• Denise M Kelley (Fit For Life Phyiscal Therapy)
• Susan F. Deranja, SLP
• Samantha Katherine Deridder, DDS
• Yaelle Dery
• Sabrina Dhillon
• Daniela Di Piero, LMFT
• Stefany Diaz, LCSW
• Richard Joseph Dickard, DDS
• Eric Josef Dickerson, DC

• Clinical Social Worker in Nevada City, CA
• Providers in Nevada City, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.