Provider Demographics
NPI:1205122165
Name:WHITENER, TYRONE MCKEEVER (BA)
Entity type:Individual
Prefix:MR
First Name:TYRONE
Middle Name:MCKEEVER
Last Name:WHITENER
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-2006
Mailing Address - Country:US
Mailing Address - Phone:864-582-5431
Mailing Address - Fax:864-582-7111
Practice Address - Street 1:1530 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-2006
Practice Address - Country:US
Practice Address - Phone:864-582-5431
Practice Address - Fax:864-582-7111
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health