Provider Demographics
NPI:1093998668
Name:DAVIS, WHITNEY J (LADC, LPC)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 E SILAS ST
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-3611
Mailing Address - Country:US
Mailing Address - Phone:918-337-6050
Mailing Address - Fax:918-337-6061
Practice Address - Street 1:417 E SILAS ST
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3611
Practice Address - Country:US
Practice Address - Phone:918-337-6050
Practice Address - Fax:918-337-6061
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK806101YA0400X
OK4121101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)