Provider Demographics
NPI:1548698640
Name:WHITAKER, JEFFREY LEE (PHD, LMFT, CFTP)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LEE
Last Name:WHITAKER
Suffix:
Gender:M
Credentials:PHD, LMFT, CFTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 S TRAFALGAR DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-5508
Mailing Address - Country:US
Mailing Address - Phone:405-361-1754
Mailing Address - Fax:
Practice Address - Street 1:10401 S TRAFALGAR DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-5508
Practice Address - Country:US
Practice Address - Phone:405-361-1754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist