Provider Demographics
NPI:1558650499
Name:WHATLEY, MACEE LANAE (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:MACEE
Middle Name:LANAE
Last Name:WHATLEY
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2257 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-6203
Mailing Address - Country:US
Mailing Address - Phone:425-422-6160
Mailing Address - Fax:
Practice Address - Street 1:2801 LOMBARD AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3619
Practice Address - Country:US
Practice Address - Phone:425-212-3993
Practice Address - Fax:425-259-3073
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60146059101YM0800X
WALH60421721101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health