Healthcare Provider Details

I. General information

NPI: 1699817718
Provider Name (Legal Business Name): WHITING & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 SE 4TH ST STE 106
LEES SUMMIT MO
64063-2908
US

IV. Provider business mailing address

618 SE 4TH ST STE 106
LEES SUMMIT MO
64063-2908
US

V. Phone/Fax

Practice location:
  • Phone: 816-554-7750
  • Fax: 816-554-7866
Mailing address:
  • Phone: 816-554-7750
  • Fax: 816-554-7866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1806
License Number StateMO

VIII. Authorized Official

Name: DR. JERRI LYNN WHITING
Title or Position: OWNER
Credential: PH.D.
Phone: 816-554-7750