Provider Demographics
NPI:1356427660
Name:GITTER, MICHAEL JONATHAN (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JONATHAN
Last Name:GITTER
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:383 W DRAKE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2884
Mailing Address - Country:US
Mailing Address - Phone:970-223-9953
Mailing Address - Fax:970-282-1782
Practice Address - Street 1:383 W DRAKE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2884
Practice Address - Country:US
Practice Address - Phone:970-223-9953
Practice Address - Fax:970-282-1782
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9922101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical