Provider Demographics
NPI:1730507385
Name:JUSTICE, WHITNEY NEVINS (LPC, LMFT)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:NEVINS
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 VILLAGE PKWY NE BLDG 8A
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4061
Mailing Address - Country:US
Mailing Address - Phone:404-907-3592
Mailing Address - Fax:
Practice Address - Street 1:171 VILLAGE PKWY NE BLDG 8A
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067
Practice Address - Country:US
Practice Address - Phone:404-907-3592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001617106H00000X
GALPC00984101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist