Sarah C Wittle, BEHAVIOR SPECIALIST

Key facts

NPI

1992533277

Entity type

Individual (NPI type 1)

Primary specialty

Specialist 174400000X

License

BH007159 (PA)

Practice address

335 S Franklin St
Wilkes Barre, PA 18702-3808

Phone

(570) 825-6425

Fax

(570) 762-9011

NPI assigned

Jul 26, 2024

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 26, 2024.

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1992533277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 RICHARD DR",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186121324",
            "telephone_number": "570-592-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 S FRANKLIN ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187023808",
            "telephone_number": "570-825-6425",
            "fax_number": "570-762-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTLE",
        "first_name": "SARAH",
        "middle_name": "C",
        "credential": "BEHAVIOR SPECIALIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "BH007159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Wilkes Barre, PA · Specialist in Pennsylvania