=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871123414
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PORSCHAE M. WHITAKER LPCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/23/2020
-----------------------------------------------------
Last Update Date | 07/23/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CINCINNATI CHILDREN'S HOSPITAL 2800 WINSLOW AVE. ML 3014 WW
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-636-4788
-----------------------------------------------------
Fax | 513-803-0823
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2800 WINSLOW AVE. ML 3014 WW
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45206-1144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-636-4788
-----------------------------------------------------
Fax | 513-803-0823
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | C.1902399
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | E.230678
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------