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General NPI Number Information
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NPI Number | 1174758213
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Entity Type | Individual
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Provider Name | JASON B WHITING PHD, LMFT
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Gender | Male
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 8200 NASHVILLE AVE SUITE 203
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City | LUBBOCK
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State | TX
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Zip | 79423-1906
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Country | US
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Telephone | 806-252-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 260 COHS - BROADWAY & AKRON TEXAS TECH UNIVERSITY
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City | LUBBOCK
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State | TX
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Zip | 79409-1210
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Country | US
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Telephone | 806-742-5050
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Fax | 806-742-5033
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 201217
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License Number State | TX
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