1427325158 NPI number — DEBRA ELAINE WHATLEY LPC, LMFT

Table of content: DEBRA ELAINE WHATLEY LPC, LMFT (NPI 1427325158)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427325158 NPI number — DEBRA ELAINE WHATLEY LPC, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHATLEY
Provider First Name:
DEBRA
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHATLEY
Provider Other First Name:
DEBBIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC, LMFT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1427325158
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
188 BUSBY ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAUGHTON
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-469-9664
Provider Business Mailing Address Fax Number:
318-377-3137

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2008 AIRLINE DRIVE, STE 300 #101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOSSIER CITY
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-469-9664
Provider Business Practice Location Address Fax Number:
318-377-3137
Provider Enumeration Date:
11/23/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  910 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 2515 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)