Provider Demographics
NPI:1245967363
Name:KELBAUGH, WHITNEY CELESTE (LCSWA)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:CELESTE
Last Name:KELBAUGH
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOUR OAKS
Mailing Address - State:NC
Mailing Address - Zip Code:27524-7244
Mailing Address - Country:US
Mailing Address - Phone:919-464-5884
Mailing Address - Fax:
Practice Address - Street 1:110 W WOOD HILL DR
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-9394
Practice Address - Country:US
Practice Address - Phone:252-648-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP01750571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical