Provider Demographics
NPI:1144890112
Name:JOEL E DE WITT LLC
Entity type:Organization
Organization Name:JOEL E DE WITT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE WITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-378-7467
Mailing Address - Street 1:3460 MIRROR LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-3017
Mailing Address - Country:US
Mailing Address - Phone:513-378-7467
Mailing Address - Fax:
Practice Address - Street 1:3460 MIRROR LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-3017
Practice Address - Country:US
Practice Address - Phone:513-378-7467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty