Individual
JUAN-ESTEFAN VITELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
706 RIDGE RD STE B, MUNSTER, IN 46321-1612
(219) 356-2240
(219) 356-2241
Mailing address
706 RIDGE RD STE B, MUNSTER, IN 46321-1612
(219) 356-2240
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/20/2016
Last updated
09/29/2022
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