Provider Demographics
NPI:1548401920
Name:WHITAKER, DAVID HUNT (PSYD, CMHC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HUNT
Last Name:WHITAKER
Suffix:
Gender:M
Credentials:PSYD, CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 581252
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84158-1252
Mailing Address - Country:US
Mailing Address - Phone:801-828-7716
Mailing Address - Fax:
Practice Address - Street 1:825 E 4800 S STE 221
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5523
Practice Address - Country:US
Practice Address - Phone:801-828-7715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4870268-6004101YM0800X
UT48702686009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT4870268-6004OtherSTATE LICENSE