Provider Demographics
NPI:1194568584
Name:WHITLEY, YASMINE (BSW)
Entity type:Individual
Prefix:
First Name:YASMINE
Middle Name:
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 DORSET CT APT 16
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-5581
Mailing Address - Country:US
Mailing Address - Phone:618-207-7907
Mailing Address - Fax:
Practice Address - Street 1:131 DORSET CT APT 16
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-5581
Practice Address - Country:US
Practice Address - Phone:618-207-7907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker