Provider Demographics
NPI:1679457642
Name:WHITMIRE, EVA LARHEA
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:LARHEA
Last Name:WHITMIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 W BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-1225
Mailing Address - Country:US
Mailing Address - Phone:765-717-9953
Mailing Address - Fax:
Practice Address - Street 1:3601 W BETHEL AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5408
Practice Address - Country:US
Practice Address - Phone:317-674-6592
Practice Address - Fax:317-674-6592
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
IN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN7657179953Medicaid