Healthcare Provider Details

I. General information

NPI: 1417861980
Provider Name (Legal Business Name): KATIA WHITEHEAD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 WHIMBREL CT
LILLINGTON NC
27546-5242
US

IV. Provider business mailing address

122 WHIMBREL CT
LILLINGTON NC
27546-5242
US

V. Phone/Fax

Practice location:
  • Phone: 910-890-0525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1261687
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: