MEDICARE: MRS. WHITNEY DEGRAFF KICKLIGHTER LMHC

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	101Y00000X	Counselor
2	101Y00000X	Counselor	MH16130	FL

General Provider Information

NPI Number	:	1881045102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WHITNEY DEGRAFF KICKLIGHTER LMHC

Provider Business Mailing Address
First Line	:	5850 T G LEE BLVD STE 205
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4408
Country	:	US
Telephone Number	:	407-630-9824
Fax Number	:

Provider Business Practice Location Address
First Line	:	5850 T G LEE BLVD STE 205
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4408
Country	:	US
Telephone Number	:	407-630-9824
Fax Number	:

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

Provider Enumeration Date	:	06/28/2016
Last Update Date	:	01/17/2024

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