Provider Demographics
NPI:1720414766
Name:WHITNEY, ELIZABETH (LCPC, LCMHC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:LCPC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 SUNSET RD
Mailing Address - Street 2:#680463
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-8777
Mailing Address - Country:US
Mailing Address - Phone:704-228-3756
Mailing Address - Fax:
Practice Address - Street 1:1101 SUNSET RD
Practice Address - Street 2:#680463
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-8777
Practice Address - Country:US
Practice Address - Phone:704-228-3756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178009352101YP2500X
NC16038101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional