Provider Demographics
NPI:1821762733
Name:WHITNER, KIMBERLY PATRICE (LPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:PATRICE
Last Name:WHITNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:10019 REISTERSTOWN RD FL 3
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3060 BUSINESS PARK DR STE C
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-5400
Practice Address - Country:US
Practice Address - Phone:678-523-9902
Practice Address - Fax:770-637-5377
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012382101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional