Provider Demographics
NPI:1366150120
Name:WHETHERHOLT, STEVEN DOUGLAS
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:WHETHERHOLT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 MAPLE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8890
Mailing Address - Country:US
Mailing Address - Phone:740-835-0041
Mailing Address - Fax:
Practice Address - Street 1:4429 MAPLE GROVE RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8890
Practice Address - Country:US
Practice Address - Phone:740-835-0041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)