Provider Demographics
NPI:1659302172
Name:WITT, MICHELLE (LMFT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:WITT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13839 S MUR LEN RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1652
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13839 S MUR LEN RD
Practice Address - Street 2:SUITE K
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1652
Practice Address - Country:US
Practice Address - Phone:913-764-5463
Practice Address - Fax:913-764-4160
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS664106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist