Healthcare Provider Details

I. General information

NPI: 1114606365
Provider Name (Legal Business Name): YOLANDA RENEE WHITNER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

287 LINDEN BLVD
BROOKLYN NY
11226-3577
US

IV. Provider business mailing address

631 BEACH 9TH ST APT 1J
FAR ROCKAWAY NY
11691-5237
US

V. Phone/Fax

Practice location:
  • Phone: 718-235-3100
  • Fax:
Mailing address:
  • Phone: 646-996-3633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number007816
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: