Provider Demographics
NPI:1982467510
Name:WHITFIELD-OLDHAM, JERNEEN (LPC)
Entity type:Individual
Prefix:
First Name:JERNEEN
Middle Name:
Last Name:WHITFIELD-OLDHAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4263 BOULDER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1397
Mailing Address - Country:US
Mailing Address - Phone:614-638-2969
Mailing Address - Fax:
Practice Address - Street 1:4263 BOULDER CREEK DR
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1397
Practice Address - Country:US
Practice Address - Phone:614-638-2969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0700033101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional