Provider Demographics
NPI:1518731488
Name:WHITFIELD, JOHN H III
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:H
Last Name:WHITFIELD
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4933 CEDAR BRUSH DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-2958
Mailing Address - Country:US
Mailing Address - Phone:469-328-7261
Mailing Address - Fax:
Practice Address - Street 1:4645 AVON LN STE 270
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1609
Practice Address - Country:US
Practice Address - Phone:469-777-8156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88162101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor