Provider Demographics
NPI:1235417007
Name:WHITLINGER, SHERYL DIANE (LMHC)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:DIANE
Last Name:WHITLINGER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1061
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:WA
Mailing Address - Zip Code:98591-1061
Mailing Address - Country:US
Mailing Address - Phone:360-957-2098
Mailing Address - Fax:
Practice Address - Street 1:205 COWLITZ ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:WA
Practice Address - Zip Code:98591
Practice Address - Country:US
Practice Address - Phone:360-864-8060
Practice Address - Fax:360-864-2076
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60249521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2014881Medicaid