Individual provider Active NPI

William David Whittinghill II, PHD, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1104068931
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 4697 Issued in FL
Practice address
4741 Atlantic Blvd
Park Pointe, Suite B-3
Jacksonville, FL 32207-1114
Phone
(904) 891-3849
NPI assigned
Mar 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 4697 FL Primary

Addresses

Primary practice location

4741 Atlantic Blvd
Park Pointe, Suite B-3
Jacksonville, FL 32207-1114

Mailing address

12766 Quincy Bay Dr
Jacksonville, FL 32224-8517

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH 4697FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1104068931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12766 QUINCY BAY DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322248517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 ATLANTIC BLVD",
            "address_2": "PARK POINTE, SUITE B-3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322071114",
            "telephone_number": "904-891-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTINGHILL",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "PHD, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 4697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.