Provider Demographics
NPI:1326447863
Name:CRISS, WHITNEY NICHOLE (MS)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:NICHOLE
Last Name:CRISS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:WHITNEY
Other - Middle Name:NICHOLE
Other - Last Name:MARANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1375 DROVER ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750-3679
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2621 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3880
Practice Address - Country:US
Practice Address - Phone:574-267-7169
Practice Address - Fax:574-269-4189
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health