Provider Demographics
NPI:1518694496
Name:DARTNELL, WHITNEY L
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:L
Last Name:DARTNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 MOUNTAIN LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT MEADOWS
Mailing Address - State:NJ
Mailing Address - Zip Code:07838-2349
Mailing Address - Country:US
Mailing Address - Phone:973-606-8176
Mailing Address - Fax:
Practice Address - Street 1:190 WELLES STREET
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-4968
Practice Address - Country:US
Practice Address - Phone:570-718-4140
Practice Address - Fax:570-718-4141
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist