Provider Demographics
NPI:1467048603
Name:STEPHENS, WHITNEY WYATT LEE (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:WYATT LEE
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 CLINTON HWY STE B
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-5224
Mailing Address - Country:US
Mailing Address - Phone:658-789-9709
Mailing Address - Fax:
Practice Address - Street 1:7311 CLINTON HWY STE B
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-5224
Practice Address - Country:US
Practice Address - Phone:865-888-5818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6906101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health