Active NPI
Traci Lynn Witthuhn, LCSW
- Clinical Social Worker
- Aurora, MO
National Provider Identifier
1629234992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2006016467
- Practice address
- 1119 S Elliott Ave
Aurora, MO 65605-2405 - Phone
- (417) 671-9856
- Fax
- (417) 671-9881
- NPI assigned
- Aug 5, 2008
- Sex
- Female
- 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 | 2006016467 | MO | Primary |
Addresses
Primary practice location
1119 S Elliott Ave
Aurora, MO 65605-2405
Mailing address
1119 S Elliott Ave
Aurora, MO 65605-2405
Phone (417) 671-9856
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006016467 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
| Center for Life Coaching and Counseling, LLC | Past | Accepting new patients | |
| Touchstone Counseling LLC | Past | Accepting new patients |
Interoperability endpoints
- traciwitthuhn@tdh.allscriptsdirect.net
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Aurora, MO
- NPI 1154515153
-
- Professional Counselor
- Ozark, MO
- NPI 1013054733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311120000000",
"number": "1629234992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1119 S ELLIOTT AVE",
"city": "AURORA",
"state": "MO",
"postal_code": "656052405",
"telephone_number": "417-671-9856",
"fax_number": "417-671-9881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1119 S ELLIOTT AVE",
"city": "AURORA",
"state": "MO",
"postal_code": "656052405",
"telephone_number": "417-671-9856",
"fax_number": "417-671-9881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTHUHN",
"first_name": "TRACI",
"middle_name": "LYNN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-05",
"last_updated": "2011-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2006016467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.