Provider Demographics
NPI:1144395583
Name:WITTY, CHERYL (LCSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:WITTY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4334 NW EXPRESSWAY ST
Mailing Address - Street 2:SUITE # 238
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1578
Mailing Address - Country:US
Mailing Address - Phone:405-286-1515
Mailing Address - Fax:405-286-1525
Practice Address - Street 1:4334 NW EXPRESSWAY ST
Practice Address - Street 2:SUITE # 238
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1578
Practice Address - Country:US
Practice Address - Phone:405-286-1515
Practice Address - Fax:405-286-1525
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK28851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical