Provider Demographics
NPI:1073401683
Name:WHITNEY, CARLY (EDS, NCSP)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 26TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-2614
Mailing Address - Country:US
Mailing Address - Phone:402-563-7060
Mailing Address - Fax:
Practice Address - Street 1:2200 26TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-2614
Practice Address - Country:US
Practice Address - Phone:402-563-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20250001993103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool