Provider Demographics
NPI:1770745937
Name:WITTE, JANE E (LCSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:WITTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 PEYTON AVE
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-7444
Mailing Address - Country:US
Mailing Address - Phone:432-263-7361
Mailing Address - Fax:432-268-5074
Practice Address - Street 1:300 W VETERANS BLVD
Practice Address - Street 2:5 CLC
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-5566
Practice Address - Country:US
Practice Address - Phone:432-263-7361
Practice Address - Fax:432-268-5074
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical