Margo Patricia Wittenbach, MA, LLPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401018816 Issued in MI

Practice address

614 Romence Rd Ste 245
Portage, MI 49024-3613

Phone

(269) 615-7637

NPI assigned

Nov 19, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

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• Kalamazoo Child and Family Counseling, PLLC

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  • NPI 1306293105

  Professional

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• Intentional Growth LLC

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  • NPI 1407396286
  NPD (past)

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1760085013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 ROMENCE RD STE 245",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490243613",
            "telephone_number": "269-615-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 ROMENCE RD STE 245",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490243613",
            "telephone_number": "269-615-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTENBACH",
        "first_name": "MARGO",
        "middle_name": "PATRICIA",
        "credential": "MA, LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401018816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwittenbach@kzoofamilycounseling.com",
            "affiliation": "N",
            "address_1": "614 Romence Rd Ste 245",
            "city": "Portage",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490243613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Evelyn Beatrice Winfield, PH.D.
• Diane Winnell, RN
• Alison Wirt
• Wise Wellness Center LLC
• Daniel Raymond Witham, PHARMD
• Erik Matthew Wittrup, LMSW
• Diane Witzel, LMSW
• Grace Josephine Wojdak, LPC
• Kari Ellen Wolf, PA-C
• Kerri Rochelle Wood

• Counselor in Portage, MI
• Providers in Portage, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.