Individual
LINDA WITTENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
2 CHURCH ST., SUITE 2 D, BURLINGTON, VT 05401
(802) 658-9590
Mailing address
51 ADAMS CT, BURLINGTON, VT 05401-4100
(802) 864-3556
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000340
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068 0000340
VERMONT LICENSE NUMBER
VT
05
—
1006778
—
VT
01
—
29516
BLUE CROSS BLUE SHIELD
VT
Enumeration date
08/01/2006
Last updated
07/08/2007
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