Provider Demographics
NPI:1861885188
Name:DEWITZ, S JOSEPH (PHD)
Entity type:Individual
Prefix:DR
First Name:S JOSEPH
Middle Name:
Last Name:DEWITZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WESTBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2060
Mailing Address - Country:US
Mailing Address - Phone:541-224-6506
Mailing Address - Fax:
Practice Address - Street 1:101 WESTBROOK WAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2060
Practice Address - Country:US
Practice Address - Phone:541-224-6506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2207103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling