Provider Demographics
NPI:1871123414
Name:WHITAKER, PORSCHAE M (LPCC)
Entity type:Individual
Prefix:MRS
First Name:PORSCHAE
Middle Name:M
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 WINSLOW AVE.
Mailing Address - Street 2:ML 3014 WW
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1144
Mailing Address - Country:US
Mailing Address - Phone:513-636-4788
Mailing Address - Fax:513-803-0823
Practice Address - Street 1:CINCINNATI CHILDREN'S HOSPITAL
Practice Address - Street 2:2800 WINSLOW AVE. ML 3014 WW
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-636-4788
Practice Address - Fax:513-803-0823
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1902399101Y00000X
OHE.230678101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor