Provider Demographics
NPI:1609417096
Name:STUBBS, WHITNEY (PHD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:STUBBS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 MAIN ST N
Mailing Address - Street 2:
Mailing Address - City:MENDENHALL
Mailing Address - State:MS
Mailing Address - Zip Code:39114-3322
Mailing Address - Country:US
Mailing Address - Phone:601-382-2783
Mailing Address - Fax:
Practice Address - Street 1:611 MAIN ST N
Practice Address - Street 2:
Practice Address - City:MENDENHALL
Practice Address - State:MS
Practice Address - Zip Code:39114-3322
Practice Address - Country:US
Practice Address - Phone:601-382-2783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0005119103T00000X
MS601066103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist