Provider Demographics
NPI:1720389760
Name:VIRGINIA D WHITTINGTON, LCSW INC.
Entity Type:Organization
Organization Name:VIRGINIA D WHITTINGTON, LCSW INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHITTINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:941-708-0896
Mailing Address - Street 1:2328 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-4957
Mailing Address - Country:US
Mailing Address - Phone:941-708-0896
Mailing Address - Fax:941-747-1696
Practice Address - Street 1:2328 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-4957
Practice Address - Country:US
Practice Address - Phone:941-708-0896
Practice Address - Fax:941-747-1696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5658261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ0035Medicare PIN