Provider Demographics
NPI:1659736296
Name:ALLEN, WHITNEY (LPCC, LCADC, TCM)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPCC, LCADC, TCM
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 390
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25708-0390
Mailing Address - Country:US
Mailing Address - Phone:304-429-1088
Mailing Address - Fax:
Practice Address - Street 1:3165 BLACKLOG RD STE B
Practice Address - Street 2:
Practice Address - City:INEZ
Practice Address - State:KY
Practice Address - Zip Code:41224-9113
Practice Address - Country:US
Practice Address - Phone:606-534-3435
Practice Address - Fax:606-534-3436
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-28
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY275344101YA0400X
171M00000X
KY289467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator