Provider Demographics
NPI:1841456621
Name:CROFUT, WHITNEY PREECE (LPC)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:PREECE
Last Name:CROFUT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:BOH
Other - Last Name:PREECE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:4511 SE HAWTHORNE BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-3170
Mailing Address - Country:US
Mailing Address - Phone:503-232-6868
Mailing Address - Fax:503-232-8197
Practice Address - Street 1:4511 SE HAWTHORNE BLVD STE 114
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-3170
Practice Address - Country:US
Practice Address - Phone:503-232-6868
Practice Address - Fax:503-232-8197
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1460101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health