Provider Demographics
NPI:1003018797
Name:WHITNEY, CAROL C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:C
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-2218
Mailing Address - Country:US
Mailing Address - Phone:757-622-7017
Mailing Address - Fax:757-640-8402
Practice Address - Street 1:222 W 19TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-2218
Practice Address - Country:US
Practice Address - Phone:757-622-7017
Practice Address - Fax:757-640-8402
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040065751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical