Provider Demographics
NPI:1457646762
Name:WHITTAM, DEBRA MARIE (MSED, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:MARIE
Last Name:WHITTAM
Suffix:
Gender:F
Credentials:MSED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6714 KELLY ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-1717
Mailing Address - Country:US
Mailing Address - Phone:412-363-7383
Mailing Address - Fax:412-363-2144
Practice Address - Street 1:6714 KELLY ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-1717
Practice Address - Country:US
Practice Address - Phone:412-363-7383
Practice Address - Fax:412-363-2144
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005890101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)