Provider Demographics
NPI:1710457874
Name:WHITBY, TYEESHA (LCPC)
Entity Type:Individual
Prefix:
First Name:TYEESHA
Middle Name:
Last Name:WHITBY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8333 MEADOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-2248
Mailing Address - Country:US
Mailing Address - Phone:703-973-1060
Mailing Address - Fax:
Practice Address - Street 1:8333 MEADOWOOD DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-2248
Practice Address - Country:US
Practice Address - Phone:703-973-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-03
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor