Provider Demographics
NPI:1871649871
Name:WHITSELL, CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:WHITSELL
Suffix:
Gender:M
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:PO BOX 990
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40423-0990
Mailing Address - Country:US
Mailing Address - Phone:859-239-2360
Mailing Address - Fax:859-239-6785
Practice Address - Street 1:130 SOUTHERN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-3223
Practice Address - Country:US
Practice Address - Phone:606-679-4782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid
KY0332015Medicare ID - Type UnspecifiedMEDICARE
KY30615058Medicaid
KY3320Medicare ID - Type UnspecifiedMEDICARE