Provider Demographics
NPI:1679964233
Name:WESTBROOK, TABITHA K (LMFT, LPC)
Entity Type:Individual
Prefix:
First Name:TABITHA
Middle Name:K
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 CAPCOM AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-6586
Mailing Address - Country:US
Mailing Address - Phone:919-891-0525
Mailing Address - Fax:
Practice Address - Street 1:152 CAPCOM AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6586
Practice Address - Country:US
Practice Address - Phone:919-891-0525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11403101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor