=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841804796
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SARAH D WHITMIRE COUNSELING AND SUPERVISION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2020
-----------------------------------------------------
Last Update Date | 09/08/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13201 NORTHWEST FWY STE 668
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77040-6008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-208-2939
-----------------------------------------------------
Fax | 832-201-7737
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13201 NORTHWEST FWY STE 668
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77040-6008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-208-2939
-----------------------------------------------------
Fax | 832-201-7737
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/LPC
-----------------------------------------------------
Name | MS. SARAH DALBY WHITMIRE
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 713-208-2939
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------