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General NPI Number Information
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NPI Number | 1245941343
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Entity Type | Organization
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Legal Business Name | WHITECHAPEL BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 141 N OAKWOOD AVE
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City | BRANDON
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State | FL
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Zip | 33510-4629
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Country | US
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Telephone | 813-445-5538
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Fax |
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Provider Business Mailing Address
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Address Line | 141 N OAKWOOD AVE
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City | BRANDON
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State | FL
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Zip | 33510-4629
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Country | US
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Telephone | 813-445-5538
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | OLATUNDE FATINIKUN
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Credential | MD
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Telephone | 813-445-5538
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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