Provider Demographics
NPI:1295814358
Name:WITMAN, ANGIE DEE HOLTON (MA, LCP, LCMFT)
Entity type:Individual
Prefix:MRS
First Name:ANGIE
Middle Name:DEE HOLTON
Last Name:WITMAN
Suffix:
Gender:
Credentials:MA, LCP, LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 ARCADE AVE
Mailing Address - Street 2:
Mailing Address - City:GOODLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67735-3424
Mailing Address - Country:US
Mailing Address - Phone:785-899-4135
Mailing Address - Fax:
Practice Address - Street 1:902 W HWY 24
Practice Address - Street 2:
Practice Address - City:GOODLAND
Practice Address - State:KS
Practice Address - Zip Code:67735-9615
Practice Address - Country:US
Practice Address - Phone:785-899-4135
Practice Address - Fax:785-899-6303
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS910101YM0800X
KS699106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health