Healthcare Provider Details

I. General information

NPI: 1942790746
Provider Name (Legal Business Name): ELAINA D WHITTENHALL ATR-BC, LPC-AT, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 BEE CAVES RD STE A204
WEST LAKE HILLS TX
78746-6429
US

IV. Provider business mailing address

3939 BEE CAVES RD STE A204
WEST LAKE HILLS TX
78746-6429
US

V. Phone/Fax

Practice location:
  • Phone: 512-675-1873
  • Fax: 512-287-5531
Mailing address:
  • Phone: 512-675-1873
  • Fax: 512-287-5531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number17-423
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number79511
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: