Provider Demographics
NPI:1760536924
Name:WITTY, JAMES WESLEY JR (LMFT, AAMFT, LCAC,)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WESLEY
Last Name:WITTY
Suffix:JR
Gender:M
Credentials:LMFT, AAMFT, LCAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IN
Mailing Address - Zip Code:46041-1171
Mailing Address - Country:US
Mailing Address - Phone:317-846-5912
Mailing Address - Fax:
Practice Address - Street 1:120 CAMILLA CT., SUITE D
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074
Practice Address - Country:US
Practice Address - Phone:317-846-5912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35000099A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist