Provider Demographics
NPI:1225436231
Name:WHITAKER, ERIC (PHD, LCSW-C, LICSW)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:WHITAKER
Suffix:
Gender:M
Credentials:PHD, LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7206 SHOCKLEY CT
Mailing Address - Street 2:
Mailing Address - City:FT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-1711
Mailing Address - Country:US
Mailing Address - Phone:202-302-4689
Mailing Address - Fax:
Practice Address - Street 1:10903 INDIAN HEAD HWY STE 404
Practice Address - Street 2:
Practice Address - City:FT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4019
Practice Address - Country:US
Practice Address - Phone:202-743-5660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD192321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical