Individual
JORDYN MARIE WITTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3071 E FRANKLIN RD STE 201, MERIDIAN, ID 83642-2376
(208) 807-2877
(208) 807-2888
Mailing address
3425 13TH ST, BAKER CITY, OR 97814-1340
(542) 523-7400
(541) 523-4927
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
23-QMHP-R-2188
OR
101YM0800X
Mental Health Counselor
LMSW-42257
ID
1041C0700X
Clinical Social Worker
8911019
ID
1041C0700X
Clinical Social Worker
LMSW-42257
ID
Other
Enumeration date
06/24/2019
Last updated
04/29/2026
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