Provider Demographics
NPI:1326423955
Name:BITTERMAN, KAITLIN (LBSW)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:BITTERMAN
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E INTERSTATE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1566
Mailing Address - Country:US
Mailing Address - Phone:701-323-2941
Mailing Address - Fax:
Practice Address - Street 1:1800 E INTERSTATE AVE STE B
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1566
Practice Address - Country:US
Practice Address - Phone:701-323-2941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND50671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical