Provider Demographics
NPI:1679249759
Name:BITAH, JAMES (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BITAH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-4533
Mailing Address - Country:US
Mailing Address - Phone:505-425-2687
Mailing Address - Fax:505-454-7198
Practice Address - Street 1:700 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4533
Practice Address - Country:US
Practice Address - Phone:505-425-2687
Practice Address - Fax:505-454-7198
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-12107104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker