MEDICARE: DR. CATHERINE MCGAVRAN WHITING PH.D.

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
1	103TC0700X	Clinical Psychologist	32016	TX
2	103TC0700X	Clinical Psychologist	0004393	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	88137A	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1639285471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE MCGAVRAN WHITING PH.D.

Provider Business Mailing Address
First Line	:	3230 E WOODMEN RD STE 110
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-8502
Country	:	US
Telephone Number	:	719-300-1780
Fax Number	:

Provider Business Practice Location Address
First Line	:	3230 E WOODMEN RD STE 110
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-8502
Country	:	US
Telephone Number	:	719-300-1780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	06/02/2021

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