Provider Demographics
NPI:1548562069
Name:CHITTIM, DAVID GEORGE (LICSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GEORGE
Last Name:CHITTIM
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 N DIVISION ST
Mailing Address - Street 2:#304
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1600
Mailing Address - Country:US
Mailing Address - Phone:509-324-3303
Mailing Address - Fax:509-483-1876
Practice Address - Street 1:4407 N DIVISION ST
Practice Address - Street 2:#304
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1600
Practice Address - Country:US
Practice Address - Phone:509-324-3303
Practice Address - Fax:509-483-1876
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-04
Last Update Date:2010-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 601535141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical