Provider Demographics
NPI:1629271317
Name:WITT, WILLIAM GEORGE (LPC, CRC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GEORGE
Last Name:WITT
Suffix:
Gender:M
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TURNER RD
Mailing Address - Street 2:
Mailing Address - City:AMSTON
Mailing Address - State:CT
Mailing Address - Zip Code:06231-1750
Mailing Address - Country:US
Mailing Address - Phone:860-228-4918
Mailing Address - Fax:
Practice Address - Street 1:21 TURNER RD
Practice Address - Street 2:
Practice Address - City:AMSTON
Practice Address - State:CT
Practice Address - Zip Code:06231-1750
Practice Address - Country:US
Practice Address - Phone:860-228-4918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000982101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional