Concordiajo Whitaker

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Citra, FL

NPI 1336739416 · NPPES record last updated Jun 1, 2023

Key facts

NPI
1336739416
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
15681 N US Highway 301
Citra, FL 32113-3154
Phone
(352) 595-5000
NPI assigned
Jan 22, 2021
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

15681 N US Highway 301
Citra, FL 32113-3154

Mailing address

216 NE 1St Ave
Ocala, FL 34470-6654
Phone (352) 732-6565

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address cwhitaker@phoenixfl.org Direct

Other providers in Citra, FL

All providers in Citra, FL · Addiction (Substance Use Disorder) Counselor in Florida

Sources for this page

Verify at the official NPI Registry.