Elizabeth Leslie Wittenberg, J.D., LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18591 Issued in MN

Practice address

3108 Hennepin Ave S
Minneapolis, MN 55408-2619

Phone

(612) 824-0802

Fax

(612) 825-1504

NPI assigned

May 10, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor

Practice roles

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.

• Hamm Memorial Psychiatric Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1609876051
  NPD (past)

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1700104130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 HENNEPIN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082619",
            "telephone_number": "612-824-0802",
            "fax_number": "612-825-1504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 HENNEPIN AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082619",
            "telephone_number": "612-824-0802",
            "fax_number": "612-825-1504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTENBERG",
        "first_name": "ELIZABETH",
        "middle_name": "LESLIE",
        "credential": "J.D., LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Elizabeth Witt, MD
• Trinity Kae Witt, MPH, RDN, LD
• Cynthia M Wittcoff, RN, CNS
• Carol Witte, RNC,NP
• Kurt Edward Witte, DDS
• Maria Mae Wittenberg, RN
• Kristina Wittenburg
• Becky L. Wittig, PT
• Ives Kenneth Wittman, LPCC
• Janet Lee Wittman, RPH

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.