DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JORDAN TYLER DEWITT, MA, LMFT, LCAS

Active Sole Proprietor

JORDAN TYLER DEWITT, MA, LMFT, LCAS is a Marriage & Family Therapist healthcare provider located in ELLERBE, North Carolina. NPI 1679064984 is currently active in the NPPES registry. Verify at CMS.

Marriage & Family Therapist · ELLERBE, NC

Registration Details

NPI Number
1679064984
Provider Type
Individual
Gender
Male
NPI Issued
May 22, 2018 (8.244684559445 yrs)
Last Updated
Jan 6, 2022
Licenses
LCAS-24343 (NC)
12093A (NC)
2160 (NC)
Sole Proprietor
Yes

Practice Information

Address
651 JONES SPRINGS CHURCH RD
ELLERBE, NC, 283388413
Browse NC providers · Browse ZIP 28338
Phone
9103187416
Primary Specialty
Marriage & Family Therapist
106H00000X
Additional Specialty
Marriage & Family Therapist
Additional Specialty
Marriage & Family Therapist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.