Provider Demographics
NPI:1871940221
Name:WHITNEY, AMY CHRISTINE (LMHC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:CHRISTINE
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 SNYDER HILL RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-8701
Mailing Address - Country:US
Mailing Address - Phone:607-227-7595
Mailing Address - Fax:
Practice Address - Street 1:200 E BUFFALO ST
Practice Address - Street 2:#302
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4258
Practice Address - Country:US
Practice Address - Phone:607-227-7595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18006504101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health