Provider Demographics
NPI:1689835274
Name:WITTE, KARIN R (LMHC)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:R
Last Name:WITTE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MISTY MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-8922
Mailing Address - Country:US
Mailing Address - Phone:415-235-2691
Mailing Address - Fax:
Practice Address - Street 1:54 MISTY MEADOW DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-8922
Practice Address - Country:US
Practice Address - Phone:561-866-6689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1689835274Medicaid