Healthcare Provider Details

I. General information

NPI: 1649801291
Provider Name (Legal Business Name): SWIYAH ZAKIRAH C WHITTINGTON LPMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

583 SHOEMAKER RD
KING OF PRUSSIA PA
19406-4201
US

IV. Provider business mailing address

901 N MARKET ST STE 100
WILMINGTON DE
19801-3064
US

V. Phone/Fax

Practice location:
  • Phone: 484-681-2170
  • Fax:
Mailing address:
  • Phone: 302-304-3810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC-0011684
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: