| Stephanie Whited, Lcsw Llc | |
|
602 Radford St Christiansburg VA 24073-3303 | |
| (540) 577-5676 | |
| Not Available |
| Full Name | Stephanie Whited, Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 602 Radford St, Christiansburg, Virginia |
| Authorized Official Name and Position | Stephanie Danielle Whited (THERAPIST) |
| Authorized Official Contact | 5405775676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Whited, Lcsw Llc 1408 2nd St Radford VA 24141-4604 Ph: (540) 577-5675 | Stephanie Whited, Lcsw Llc 602 Radford St Christiansburg VA 24073-3303 Ph: (540) 577-5676 |
| NPI Number | 1780145433 |
|---|---|
| Provider Enumeration Date | 03/26/2019 |
| Last Update Date | 03/26/2019 |
| Medicare PECOS PAC ID | 9537402664 |
|---|---|
| Medicare Enrollment ID | O20190513002431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780145433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie Whited |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215478607 PECOS PAC ID: 1254603012 Enrollment ID: I20170815001333 |
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