Individual provider Active NPI

Christine Jenny Whittaker, MA, LMFT

  • Marriage & Family Therapist
  • Tampa, FL
National Provider Identifier
1073815056
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT3108 Issued in FL
Practice address
14502 North Dale Mabry Hwy
Suite#200
Tampa, FL 33618-2746
Phone
(813) 240-0855
Fax
(727) 800-1854
NPI assigned
Nov 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MT3018 FL
Marriage & Family Therapist 106H00000X MT3108 FL Primary

Addresses

Primary practice location

14502 North Dale Mabry Hwy
Suite#200
Tampa, FL 33618-2746

Mailing address

14502 North Dale Mabry Hwy
Suite#200
Tampa, FL 33618-2746
Phone (813) 240-0855

Other identifiers 1

IdentifierTypeStateIssuer
023910300MedicaidFL

Other names 1

  • Mrs. Christine Whittaker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MT3018FLMDCounselor
MT3108FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Whittaker Family Services, LLC Community/Behavioral Health Current Accepting new patients

Locations

14502 N Dale Mabry Hwy
Ste 200
Tampa, FL 33618
Phone (813) 724-3868

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1073815056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14502 NORTH DALE MABRY HWY",
            "address_2": "SUITE#200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182746",
            "telephone_number": "813-240-0855",
            "fax_number": "727-800-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 NORTH DALE MABRY HWY",
            "address_2": "SUITE#200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182746",
            "telephone_number": "813-240-0855",
            "fax_number": "727-800-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "CHRISTINE",
        "middle_name": "JENNY",
        "name_prefix": "Mrs.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-24",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MT3018",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023910300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "WHITTAKER",
            "prefix": "MRS.",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.