Provider Demographics
NPI:1710616578
Name:WHITTENBURG, CARI (LCSW)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:
Last Name:WHITTENBURG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-1373
Mailing Address - Country:US
Mailing Address - Phone:940-539-3200
Mailing Address - Fax:
Practice Address - Street 1:507 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-1373
Practice Address - Country:US
Practice Address - Phone:940-626-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX686981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical