Provider Demographics
NPI:1497183982
Name:ROSENBAUM, WHITNEY PAIGE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:PAIGE
Last Name:ROSENBAUM
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 1:2809 FOREST HOME RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5320
Mailing Address - Country:US
Mailing Address - Phone:866-972-1268
Mailing Address - Fax:501-663-2199
Practice Address - Street 1:1719 MERRILL DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-4009
Practice Address - Country:US
Practice Address - Phone:501-663-2199
Practice Address - Fax:501-663-2234
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7093-C1041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR7093-COtherAR STATE LICENSE