Provider Demographics
NPI:1780951178
Name:VITTI, DEVON (LCSW; LCSW-C)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:VITTI
Suffix:
Gender:M
Credentials:LCSW; LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 BURRS LN
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6052
Mailing Address - Country:US
Mailing Address - Phone:631-253-3480
Mailing Address - Fax:631-253-3483
Practice Address - Street 1:151 BURRS LN
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-6052
Practice Address - Country:US
Practice Address - Phone:631-253-3480
Practice Address - Fax:631-253-3483
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00013811041C0700X
MD192211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical