Healthcare Provider Details

I. General information

NPI: 1811588023
Provider Name (Legal Business Name): ALLISON CHRISTA BARNES WHITNEY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2021
Last Update Date: 01/30/2021
Certification Date: 01/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 BRIGHTSEAT RD
LANDOVER MD
20785-4725
US

IV. Provider business mailing address

603 CARLTON OTTO LN APT 22
ODENTON MD
21113-2189
US

V. Phone/Fax

Practice location:
  • Phone: 240-389-5911
  • Fax:
Mailing address:
  • Phone: 385-309-8009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number26564
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number80642
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: