Provider Demographics
NPI:1205234283
Name:WHATLEY, GINGER (MS, LPC, LCDC)
Entity type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:
Last Name:WHATLEY
Suffix:
Gender:F
Credentials:MS, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 S INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:CO
Mailing Address - Zip Code:81082-3126
Mailing Address - Country:US
Mailing Address - Phone:719-846-4416
Mailing Address - Fax:719-846-6408
Practice Address - Street 1:417 S INDIANA AVE
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CO
Practice Address - Zip Code:81082-3126
Practice Address - Country:US
Practice Address - Phone:719-846-4416
Practice Address - Fax:719-846-6408
Is Sole Proprietor?:No
Enumeration Date:2014-12-08
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12123101YA0400X
COLPC.0012841101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)