Healthcare Provider Details

I. General information

NPI: 1679490882
Provider Name (Legal Business Name): WHITNEY L KIRK MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7305 N MILITARY TRL
RIVIERA BEACH FL
33410-7417
US

IV. Provider business mailing address

7305 N MILITARY TRL
RIVIERA BEACH FL
33410-7417
US

V. Phone/Fax

Practice location:
  • Phone: 561-875-3718
  • Fax:
Mailing address:
  • Phone: 561-875-3718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number19006
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: