Provider Demographics
NPI:1063617983
Name:WHITAKER, BETH CAUSBY (PSYCHOLOGICAL ASSOC)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:CAUSBY
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:PSYCHOLOGICAL ASSOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 MOUNTAIN SHADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-9614
Mailing Address - Country:US
Mailing Address - Phone:828-433-8042
Mailing Address - Fax:
Practice Address - Street 1:1333 MOUNTAIN SHADOWS DR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-9614
Practice Address - Country:US
Practice Address - Phone:828-433-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC#0863103TB0200X, 103TC1900X, 103TC2200X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities