Charlene Frances Witteneberg, DPA LPC MA MS NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

75941 Issued in TX

Practice address

1106 S Mays St
Round Rock, TX 78664-6783

Phone

(410) 972-1384

NPI assigned

Jul 24, 2019

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)

Not enrolled

Credentials

Master of Arts, Master of Science

State licenses

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1760036123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3664 ROSALINA LOOP",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786655681",
            "telephone_number": "410-972-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 S MAYS ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646783",
            "telephone_number": "410-972-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTENEBERG",
        "first_name": "CHARLENE",
        "middle_name": "FRANCES",
        "name_prefix": "Ms.",
        "credential": "DPA LPC MA MS NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "75941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "75941",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eridian Winter, LMFT-A
• Jakob Ryan Wisbrock
• Araceli H. Wisnoski, B.S., R.PH.
• Mandy Withers
• Within Her LLC
• Allison Mary Wolf, FNP
• Womens Health Associates of Central Texas
• Leora Wong, BA, MS
• Mitchell Wong, MD
• Jessica Ann Wood, PT, DPT

• Mental Health Counselor in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.