Provider Demographics
NPI:1932452125
Name:WHITAKER, CARRIE LEONHARDT (LCSW)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LEONHARDT
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 KINGSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4063
Mailing Address - Country:US
Mailing Address - Phone:919-698-2214
Mailing Address - Fax:
Practice Address - Street 1:414 KINGSWOOD DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-4063
Practice Address - Country:US
Practice Address - Phone:919-698-2214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0072971041C0700X
NCC0093031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical