Provider Demographics
NPI:1891939179
Name:WHITAKER, LAKEYLA TAMIKA (MA, LLPC)
Entity Type:Individual
Prefix:MS
First Name:LAKEYLA
Middle Name:TAMIKA
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9599 HEMINGWAY
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2202
Mailing Address - Country:US
Mailing Address - Phone:313-506-2368
Mailing Address - Fax:
Practice Address - Street 1:35300 NANKIN BLVD
Practice Address - Street 2:SUITE 601
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-7222
Practice Address - Country:US
Practice Address - Phone:734-261-1842
Practice Address - Fax:734-261-5287
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009264101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional