Provider Demographics
NPI:1093269367
Name:WHITAKER, BRANDI (LPCC)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCC
Mailing Address - Street 1:517 SAMPSON DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-8865
Mailing Address - Country:US
Mailing Address - Phone:502-229-5958
Mailing Address - Fax:
Practice Address - Street 1:1015 DORSEY LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223
Practice Address - Country:US
Practice Address - Phone:502-245-1576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171785101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health