Healthcare Provider Details

I. General information

NPI: 1174281398
Provider Name (Legal Business Name): WHITNEY TYNES LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 N WALSH ST
CARSON CITY NV
89701-4268
US

IV. Provider business mailing address

PO BOX 1852
MINDEN NV
89423-1852
US

V. Phone/Fax

Practice location:
  • Phone: 775-298-6386
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number5360
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: