Provider Demographics
NPI:1891759122
Name:WHITTEN, HARRIET D (LPC)
Entity Type:Individual
Prefix:MRS
First Name:HARRIET
Middle Name:D
Last Name:WHITTEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-3912
Mailing Address - Country:US
Mailing Address - Phone:903-794-0354
Mailing Address - Fax:903-794-0354
Practice Address - Street 1:1920 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-3912
Practice Address - Country:US
Practice Address - Phone:903-794-0354
Practice Address - Fax:903-794-0354
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16187101YP2500X
ARP9803005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5U611OtherARKANSAS BLUE CROSS BLUE
148141OtherVALUEOPTIONS
AR6177LCOtherCORPHEALTH ARKANSAS