Glenn Douglas Campbell Whitelaw, LMSW, LMFT, ACSW, NA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801017103 Issued in MI

Practice address

114 Orchard Lake Rd
Pontiac, MI 48341-2244

Phone

(248) 858-7766

Fax

(248) 858-7201

NPI assigned

Aug 9, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1659650638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 E WEST MAPLE RD",
            "address_2": "SUITE D-407",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483903801",
            "telephone_number": "248-624-3811",
            "fax_number": "248-624-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ORCHARD LAKE RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412244",
            "telephone_number": "248-858-7766",
            "fax_number": "248-858-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITELAW",
        "first_name": "GLENN",
        "middle_name": "DOUGLAS CAMPBELL",
        "credential": "LMSW, LMFT, ACSW, NA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-09",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801017103",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101005142",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa M Whalen, PAC
• Caesar White
• Ciara White
• Jeanette Elizabeth White
• Nicole White, EMT-B
• Meghan Ann Whitenton, LMSW
• Christopher Wicks
• Wilkinson Eye Center PC
• Carol D Wilkinson, APRN, BC
• William Scott Wilkinson, M.D.

• Clinical Social Worker in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.