Provider Demographics
NPI:1821762196
Name:WHITFIELD, MARCUS RASHAD (LGPC)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:RASHAD
Last Name:WHITFIELD
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 W VILLAGE AVE APT 5047
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-5241
Mailing Address - Country:US
Mailing Address - Phone:804-370-1067
Mailing Address - Fax:
Practice Address - Street 1:4300 W VILLAGE AVE APT 5047
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-5241
Practice Address - Country:US
Practice Address - Phone:804-370-1067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC00770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional