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General NPI Number Information
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NPI Number | 1104068931
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Entity Type | Individual
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Provider Name | WILLIAM DAVID WHITTINGHILL II PHD, LMHC
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Gender | Male
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Dates
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Enumeration Date | 03/25/2009
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Last Update Date | 03/25/2009
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Provider Practice Location Address
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Address Line | 4741 ATLANTIC BLVD PARK POINTE, SUITE B-3
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City | JACKSONVILLE
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State | FL
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Zip | 32207-1114
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Country | US
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Telephone | 904-891-3849
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Fax |
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Provider Business Mailing Address
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Address Line | 12766 QUINCY BAY DR
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City | JACKSONVILLE
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State | FL
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Zip | 32224-8517
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 4697
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License Number State | FL
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