Healthcare Provider Details

I. General information

NPI: 1770107401
Provider Name (Legal Business Name): STEVEN KYLE WHITFIELD LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date: 05/27/2026
Reactivation Date: 07/15/2026

III. Provider practice location address

3624 WHITETAIL LN
PENSACOLA FL
32526-4463
US

IV. Provider business mailing address

3624 WHITETAIL LN
PENSACOLA FL
32526-4463
US

V. Phone/Fax

Practice location:
  • Phone: 850-637-6216
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW24939
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: