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General NPI Number Information
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NPI Number | 1427455211
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Entity Type | Individual
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Provider Name | LYNETTE WHITNEY
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Gender | Female
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Dates
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Enumeration Date | 11/23/2014
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | 8134 OLD KEENE MILL RD
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1800
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Country | US
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Telephone | 703-569-8731
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Fax | 703-569-7248
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Provider Business Mailing Address
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Address Line | 8134 OLD KEENE MILL RD
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1800
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Country | US
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Telephone | 703-569-8731
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Fax | 703-569-7248
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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 |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY31051
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | PSB94023440
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810006344
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License Number State | VA
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