IVES KENNETH WITTMAN


Address: 1828 Jefferson St Ne, Minneapolis, MN 55418-4427
Phone: 6512450417

IVES KENNETH WITTMAN (NPI# 1356949432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356949432
Entity Type Individual
Full Name IVES KENNETH WITTMAN
Credential LPCC
Practice Address 1828 Jefferson St Ne
Minneapolis
MN 55418-4427
Mailing Address 767 Heinel Dr
Roseville
MN 55113-2152
Practice Telephone 6512450417
Mailing Telephone 6127412152
Enumeration Date 2020-10-12
Last Update Date 2020-10-12
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
CC02438 MN Behavioral Health & Social Service Providers

Office Location

Street Address 1828 JEFFERSON ST NE
City MINNEAPOLIS
State MN
Zip Code 55418-4427

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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City MINNEAPOLIS
Zip Code 55418

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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