Dimitri Vitebsky, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

74810 Issued in CA

Practice address

427 Encinal Canyon Rd
Malibu, CA 90265-2404

Phone

(213) 266-2857

NPI assigned

Sep 1, 2010

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1861709636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 ENCINAL CANYON RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902652404",
            "telephone_number": "213-266-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 ENCINAL CANYON RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902652404",
            "telephone_number": "213-266-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITEBSKY",
        "first_name": "DIMITRI",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "74810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Francine Vogler, M.D.
• Blaire Ann Christina Ward-Denson, MSC, DOCTORAL TRAINE
• Shannon Gerald Watson, D.C.
• Marion West
• Westside Sober Living Centers, Inc (Promises Malibu Vista)

• Clinical Social Worker in Malibu, CA
• Providers in Malibu, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.