Provider Demographics
NPI:1235600289
Name:WHITBY, EBONY (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:EBONY
Middle Name:
Last Name:WHITBY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MISS
Other - First Name:EBONY
Other - Middle Name:
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:3590B PELHAM PKWY # 217
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2034
Mailing Address - Country:US
Mailing Address - Phone:706-575-3921
Mailing Address - Fax:
Practice Address - Street 1:2163 PELHAM PKWY STE 212
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1160
Practice Address - Country:US
Practice Address - Phone:205-730-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4095C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical