Provider Demographics
NPI:1962034116
Name:WHITTINGTON, JUANITA JACQUELINE (LCPC)
Entity type:Individual
Prefix:
First Name:JUANITA
Middle Name:JACQUELINE
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:JUANITA
Other - Middle Name:JACQUELINE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:5102 DANEBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-2383
Mailing Address - Country:US
Mailing Address - Phone:773-882-6916
Mailing Address - Fax:
Practice Address - Street 1:600 CONGRESS AVE FL 14
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3263
Practice Address - Country:US
Practice Address - Phone:818-253-1865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009715101YM0800X
TX81411101YM0800X
CA9225101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health