Provider Demographics
NPI:1780135871
Name:COULSON, WHITNEY LEIGH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:LEIGH
Last Name:COULSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:LEIGH
Other - Last Name:COULSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1134 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4816
Mailing Address - Country:US
Mailing Address - Phone:248-752-0509
Mailing Address - Fax:
Practice Address - Street 1:640 N OLD WOODWARD AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3881
Practice Address - Country:US
Practice Address - Phone:248-752-0509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094616-011041C0700X
MI6801100194101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical