Provider Demographics
NPI:1891089694
Name:WHITT, LYNDA (LCSW)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:WHITT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LYNDA
Other - Middle Name:
Other - Last Name:MERRILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:502 FARRELL DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-3717
Mailing Address - Country:US
Mailing Address - Phone:859-331-3292
Mailing Address - Fax:859-578-2864
Practice Address - Street 1:329 FLOYD DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008-8261
Practice Address - Country:US
Practice Address - Phone:502-732-1082
Practice Address - Fax:859-567-1253
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY610661458OtherGROUP TAX ID NUMBER