Provider Demographics
NPI:1235026238
Name:WHITEHEAD, JAMES SPENCER JR (APC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:SPENCER
Last Name:WHITEHEAD
Suffix:JR
Gender:M
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 JOHNSTON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5532
Mailing Address - Country:US
Mailing Address - Phone:912-712-6533
Mailing Address - Fax:
Practice Address - Street 1:2151 ELGIN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-1986
Practice Address - Country:US
Practice Address - Phone:912-428-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC009760101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor