Provider Demographics
NPI:1124218896
Name:WITHEE, ABIGAIL (MFT)
Entity Type:Individual
Prefix:MISS
First Name:ABIGAIL
Middle Name:
Last Name:WITHEE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 S ELENA AVE # 105
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5710
Mailing Address - Country:US
Mailing Address - Phone:310-243-6580
Mailing Address - Fax:888-610-6302
Practice Address - Street 1:1848 S ELENA AVE # 105
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277
Practice Address - Country:US
Practice Address - Phone:310-243-6580
Practice Address - Fax:888-610-6302
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC48372101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health