Provider Demographics
NPI:1609502319
Name:GITS, CALLIE A (PLADC)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:A
Last Name:GITS
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-5805
Mailing Address - Country:US
Mailing Address - Phone:308-675-3345
Mailing Address - Fax:308-675-3342
Practice Address - Street 1:406 W KOENIG ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-6516
Practice Address - Country:US
Practice Address - Phone:308-382-0422
Practice Address - Fax:308-675-3342
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1990101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)