Provider Demographics
NPI:1639351844
Name:GITAR, JAMES DENNIS (LICSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DENNIS
Last Name:GITAR
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 1:6550 YORK AVE S STE 503
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2336
Mailing Address - Country:US
Mailing Address - Phone:952-426-3034
Mailing Address - Fax:612-540-0460
Practice Address - Street 1:6550 YORK AVE S STE 503
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:952-426-3034
Practice Address - Fax:612-540-0460
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN67141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical