Provider Demographics
NPI:1871828392
Name:KITTS, WILLARD F (LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLARD
Middle Name:F
Last Name:KITTS
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 1:920 CARDENAS DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1720
Mailing Address - Country:US
Mailing Address - Phone:505-266-8166
Mailing Address - Fax:505-266-8168
Practice Address - Street 1:920 CARDENAS DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1720
Practice Address - Country:US
Practice Address - Phone:505-266-8166
Practice Address - Fax:505-266-8168
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-088801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical