Healthcare Provider Details
I. General information
NPI: 1588461099
Provider Name (Legal Business Name): SHAYLAN WHITT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/03/2025
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 FOXGLOVE DR
MT STERLING KY
40353-9769
US
IV. Provider business mailing address
PO BOX 790
ASHLAND KY
41105-0790
US
V. Phone/Fax
- Phone: 866-233-1955
- Fax:
- Phone: 606-329-8588
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 00001644 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: