Active NPI
Deborah Wittekind, CASAC
- Addiction (Substance Use Disorder) Counselor
- Holbrook, NY
National Provider Identifier
1679879985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 10681
- Practice address
- 24 Summerwood Rd
Holbrook, NY 11741-5612 - Phone
- (631) 472-2851
- Fax
- (631) 472-2851
- NPI assigned
- Feb 3, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 10681 | NY | Primary |
Addresses
Primary practice location
24 Summerwood Rd
Holbrook, NY 11741-5612
Mailing address
24 Summerwood Rd
Holbrook, NY 11741-5612
Phone (631) 472-2851
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 |
|---|---|---|---|
| 10681 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296691200000",
"number": "1679879985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 SUMMERWOOD RD",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117415612",
"telephone_number": "631-472-2851",
"fax_number": "631-472-2851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 SUMMERWOOD RD",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117415612",
"telephone_number": "631-472-2851",
"fax_number": "631-472-2851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTEKIND",
"first_name": "DEBORAH",
"name_prefix": "Ms.",
"credential": "CASAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-03",
"last_updated": "2011-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "10681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.