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General NPI Number Information
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NPI Number | 1215448980
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Entity Type | Individual
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Provider Name | KOLLETTE WHITLEY LPC
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Gender | Female
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 17350 STATE HIGHWAY 249 STE 220-6454
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City | HOUSTON
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State | TX
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Zip | 77064-1147
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Country | US
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Telephone | 361-238-7355
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 417
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City | GANADO
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State | TX
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Zip | 77962-0417
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Country | US
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Telephone | 361-491-1443
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 73165
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 74488
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License Number State | TX
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