Provider Demographics
NPI:1346910619
Name:WHITTLE, REBECCA CATHERINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:CATHERINE
Last Name:WHITTLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1663 SARA HUNTER LN NW
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-8634
Mailing Address - Country:US
Mailing Address - Phone:850-264-1999
Mailing Address - Fax:
Practice Address - Street 1:1663 SARA HUNGER LN NW
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061
Practice Address - Country:US
Practice Address - Phone:850-264-1999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0070711041C0700X
FLSW138931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical