Individual
JOEL DE WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4225 101ST ST UNIT 580302, PLEASANT PRAIRIE, WI 53158-6813
(262) 320-7740
Mailing address
4225 101ST ST # 580302, PLEASANT PRAIRIE, WI 53158-9997
(262) 320-7740
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15673-132
WI
101YM0800X
Mental Health Counselor
C501198
OH
101YP2500X
Professional Counselor
Primary
4756-125
WI
Other
Enumeration date
10/20/2009
Last updated
05/28/2020
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