Provider Demographics
NPI:1700357050
Name:WHITSELL COUNSELING & SUPERVISION
Entity Type:Organization
Organization Name:WHITSELL COUNSELING & SUPERVISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:WHITSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:859-339-0582
Mailing Address - Street 1:116 ANGELA DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-1073
Mailing Address - Country:US
Mailing Address - Phone:859-339-0582
Mailing Address - Fax:859-236-0854
Practice Address - Street 1:416 S 4TH ST STE 1
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2085
Practice Address - Country:US
Practice Address - Phone:859-339-0582
Practice Address - Fax:859-236-0854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty