Provider Demographics
NPI:1295247740
Name:WHITAKER, NIASHAY (LMHCA, CDPT)
Entity type:Individual
Prefix:MRS
First Name:NIASHAY
Middle Name:
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:LMHCA, CDPT
Other - Prefix:
Other - First Name:NIASHAY
Other - Middle Name:
Other - Last Name:WHITAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1033 SW 152ND ST
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1845
Mailing Address - Country:US
Mailing Address - Phone:206-696-2097
Mailing Address - Fax:
Practice Address - Street 1:1033 SW 152ND ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1845
Practice Address - Country:US
Practice Address - Phone:206-696-2097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60799189101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health