Provider Demographics
NPI:1255352720
Name:WHITTINGTON, MOROLINE III (MSW LCSW)
Entity type:Individual
Prefix:
First Name:MOROLINE
Middle Name:
Last Name:WHITTINGTON
Suffix:III
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-3610
Mailing Address - Country:US
Mailing Address - Phone:636-294-3490
Mailing Address - Fax:636-294-3490
Practice Address - Street 1:30 BAY HILL DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-3610
Practice Address - Country:US
Practice Address - Phone:636-294-3490
Practice Address - Fax:636-294-3490
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010129751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical