Provider Demographics
NPI:1841894987
Name:WHITTINGTON, LATOYL (QMHP)
Entity type:Individual
Prefix:
First Name:LATOYL
Middle Name:
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 PLANK RD # 323
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5226
Mailing Address - Country:US
Mailing Address - Phone:571-721-8971
Mailing Address - Fax:
Practice Address - Street 1:800 CORPORATE DR STE 301
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-4889
Practice Address - Country:US
Practice Address - Phone:703-884-3952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0732003202104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker