Provider Demographics
NPI:1912143744
Name:WHITNEY, BRIAN LEWIS (MA LMHC LMFT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:LEWIS
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:MA LMHC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 116TH AVE NE STE 224
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3064
Mailing Address - Country:US
Mailing Address - Phone:425-283-1313
Mailing Address - Fax:425-283-1316
Practice Address - Street 1:1611 116TH AVE NE STE 224
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3064
Practice Address - Country:US
Practice Address - Phone:425-283-1313
Practice Address - Fax:425-283-1316
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003933101YM0800X
WALF00001219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health