Healthcare Provider Details

I. General information

NPI: 1205234283
Provider Name (Legal Business Name): GINGER WHATLEY MS, LPC, LCDC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 GOLD AVE SW STE 1300
ALBUQUERQUE NM
87102-3274
US

IV. Provider business mailing address

417 S INDIANA AVE
TRINIDAD CO
81082-3126
US

V. Phone/Fax

Practice location:
  • Phone: 505-715-4610
  • Fax:
Mailing address:
  • Phone: 719-846-4416
  • Fax: 719-846-6408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberCTB-2025-0208
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12123
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0012841
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: