Healthcare Provider Details

I. General information

NPI: 1114443694
Provider Name (Legal Business Name): NAKEISHA LATTOIA WHITFIELD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4271 121ST TER N
ROYAL PALM BEACH FL
33411-8918
US

IV. Provider business mailing address

7754 OKEECHOBEE BLVD # 1041
WEST PALM BEACH FL
33411-2103
US

V. Phone/Fax

Practice location:
  • Phone: 803-630-1462
  • Fax:
Mailing address:
  • Phone: 803-630-1462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC013000
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904011800
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW21391
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW007070
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: