Provider Demographics
NPI:1639224462
Name:WHYTE, LLOYD WAYNE (MSW LCSW MO LICENSE)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:WAYNE
Last Name:WHYTE
Suffix:
Gender:M
Credentials:MSW LCSW MO LICENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4304 SAVANNAH CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-4250
Mailing Address - Country:US
Mailing Address - Phone:573-446-0849
Mailing Address - Fax:573-446-0849
Practice Address - Street 1:4304 SAVANNAH CT
Practice Address - Street 2:STE 101
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-4250
Practice Address - Country:US
Practice Address - Phone:573-446-0849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO0016741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO493238902Medicaid
MO737320OtherWELLCARE/MOCARE
MO800445OtherDEPT OF MENTAL HEALTH
MO405495OtherHEALTH CARE USA
MO990001071Medicare UPIN
MO493238902Medicaid