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NPI Code Detail

MEDICARE: MR. ROBERT DAVID WHITING MSW, LCSW

MEDICARE: MR. ROBERT DAVID WHITING MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW.09926304CO
21041C0700XClinical Social Worker149009582IL

General Provider Information

NPI Number : 1124247556
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT DAVID WHITING MSW, LCSW
Provider Business Mailing Address
First Line : 1065 NE 125TH ST STE 409
Second Line :
City : NORTH MIAMI
State : FL
Zip : 33161-5834
Country : US
Telephone Number : 888-852-6672
Fax Number : 305-891-4228
Provider Business Practice Location Address
First Line : 6915 TUTT BLVD STE 110B
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80923-3591
Country : US
Telephone Number : 719-445-1292
Fax Number : 719-591-6486
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 12/05/2019

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