Provider Demographics
NPI:1790502508
Name:CAMPBELL, WHITNEY CATHERINE
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:CATHERINE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LIBERTY STREET WASHINGTON HTS
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-6125
Mailing Address - Country:US
Mailing Address - Phone:914-562-4041
Mailing Address - Fax:
Practice Address - Street 1:1441 BROADWAY FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-1879
Practice Address - Country:US
Practice Address - Phone:646-389-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013647101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health