Provider Demographics
NPI:1396104154
Name:WHITTAKER, CARRIE (LMHC, LPC, NCC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:WHITTAKER
Suffix:
Gender:F
Credentials:LMHC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 FLINTLOCK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 W END AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5708
Practice Address - Country:US
Practice Address - Phone:914-552-2179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006331-1101YM0800X
CT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health