Provider Demographics
NPI:1952669400
Name:WHITTAKER, STEPHENI (BSW)
Entity Type:Individual
Prefix:MRS
First Name:STEPHENI
Middle Name:
Last Name:WHITTAKER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 LOUDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-7050
Mailing Address - Country:US
Mailing Address - Phone:716-244-7482
Mailing Address - Fax:
Practice Address - Street 1:2960 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-1952
Practice Address - Country:US
Practice Address - Phone:727-479-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor