Healthcare Provider Details

I. General information

NPI: 1659464873
Provider Name (Legal Business Name): E S WHITAKER & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 EXECUTIVE DRIVE TOWER BOX 7
HAMPTON VA
23666
US

IV. Provider business mailing address

2101 EXECUTIVE DRIVE TOWER BOX 7
HAMPTON VA
23666
US

V. Phone/Fax

Practice location:
  • Phone: 757-838-4144
  • Fax: 757-827-8193
Mailing address:
  • Phone: 757-838-4144
  • Fax: 757-827-8193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0904001171
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number0904001171
License Number StateVA

VIII. Authorized Official

Name: MS. ELAINE SANDRA WHITAKER
Title or Position: OWNER
Credential: LCSW
Phone: 757-838-4144