Provider Demographics
NPI:1972649341
Name:WHISENHUNT, CHARLES LEE (LCPC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:LEE
Last Name:WHISENHUNT
Suffix:
Gender:M
Credentials:LCPC
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 1361
Mailing Address - Street 2:
Mailing Address - City:POPLAR
Mailing Address - State:MT
Mailing Address - Zip Code:59255-1361
Mailing Address - Country:US
Mailing Address - Phone:406-768-5988
Mailing Address - Fax:
Practice Address - Street 1:104 4TH AVE. W.
Practice Address - Street 2:
Practice Address - City:POPLAR
Practice Address - State:MT
Practice Address - Zip Code:59255-1361
Practice Address - Country:US
Practice Address - Phone:406-768-5988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT068-LCPC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional