Provider Demographics
NPI:1962940098
Name:WHITFIELD, DARREN (LPC)
Entity type:Individual
Prefix:
First Name:DARREN
Middle Name:
Last Name:WHITFIELD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 BRISBANE COURT
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263
Mailing Address - Country:US
Mailing Address - Phone:770-842-7228
Mailing Address - Fax:
Practice Address - Street 1:49 BRISBANE CT
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-2370
Practice Address - Country:US
Practice Address - Phone:770-842-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009213101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional