Healthcare Provider Details

I. General information

NPI: 1871123414
Provider Name (Legal Business Name): PORSCHAE M. WHITAKER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 07/23/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CINCINNATI CHILDREN'S HOSPITAL 2800 WINSLOW AVE. ML 3014 WW
CINCINNATI OH
45229
US

IV. Provider business mailing address

2800 WINSLOW AVE. ML 3014 WW
CINCINNATI OH
45206-1144
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4788
  • Fax: 513-803-0823
Mailing address:
  • Phone: 513-636-4788
  • Fax: 513-803-0823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.1902399
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE.230678
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: