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General NPI Number Information
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NPI Number | 1295863629
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Entity Type | Individual
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Provider Name | LUCY ANN WHITELOCKE M.S.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 11/17/2016
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Provider Practice Location Address
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Address Line | 120 S UNIVERSITY DR STE F
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City | PLANTATION
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State | FL
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Zip | 33324-3346
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Country | US
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Telephone | 954-610-0450
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Fax |
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Provider Business Mailing Address
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Address Line | 11193 NW 37TH ST
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City | SUNRISE
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State | FL
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Zip | 33351-7581
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Country | US
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Telephone | 954-610-0450
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MT 2646
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License Number State | FL
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