Provider Demographics
NPI:1790111318
Name:DEWITT, CHRISTOPHER PAUL (BA, CAP, CPRP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:PAUL
Last Name:DEWITT
Suffix:
Gender:M
Credentials:BA, CAP, CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 31ST ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-1422
Mailing Address - Country:US
Mailing Address - Phone:727-209-2456
Mailing Address - Fax:727-209-0297
Practice Address - Street 1:555 31ST ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-1422
Practice Address - Country:US
Practice Address - Phone:727-209-2456
Practice Address - Fax:727-209-0297
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL164942OtherCERTIFIED PSYCHIATRIC REHABILITATION PRACTITIONER
FL1812OtherCERTIFIED ADDICTION PROFESSIONAL