Healthcare Provider Details

I. General information

NPI: 1427325158
Provider Name (Legal Business Name): DEBRA ELAINE WHATLEY LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBBIE WHATLEY LPC, LMFT

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 AIRLINE DRIVE, STE 300 #101
BOSSIER CITY LA
71111
US

IV. Provider business mailing address

188 BUSBY ROAD
HAUGHTON LA
71037
US

V. Phone/Fax

Practice location:
  • Phone: 318-469-9664
  • Fax: 318-377-3137
Mailing address:
  • Phone: 318-469-9664
  • Fax: 318-377-3137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2515
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number910
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: