Provider Demographics
NPI:1154724474
Name:WHITNEY, ALISHA KRISTINE (LMSW)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:KRISTINE
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MAYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT RIDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48069-1232
Mailing Address - Country:US
Mailing Address - Phone:616-485-9855
Mailing Address - Fax:
Practice Address - Street 1:30701 WOODWARD AVE
Practice Address - Street 2:SUITE #N200
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0987
Practice Address - Country:US
Practice Address - Phone:616-485-9855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL204230104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker