Provider Demographics
NPI:1114334265
Name:WITT, COURTNEY (LCMFT, LMFT)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:WITT
Suffix:
Gender:F
Credentials:LCMFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 POYNTZ AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-4361
Mailing Address - Country:US
Mailing Address - Phone:785-341-2337
Mailing Address - Fax:913-951-0808
Practice Address - Street 1:1201 POYNTZ AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4361
Practice Address - Country:US
Practice Address - Phone:785-341-2337
Practice Address - Fax:913-951-0808
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2019-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018043791106H00000X
KS2786106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist