Whitney Nellore, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P1612195 Issued in AR

Practice address

2104 SE 14TH St
Bentonville, AR 72712-6902

Phone

(417) 389-3348

NPI assigned

Jul 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584230400000",
    "number": "1689080871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126902",
            "telephone_number": "417-389-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126902",
            "telephone_number": "417-389-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLORE",
        "first_name": "WHITNEY",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2020-03-15",
        "certification_date": "2020-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P1612195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "P1612195  LPC",
            "identifier": "P1612195",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "whitney@bentonvillecounseling.com",
            "affiliation": "N",
            "address_1": "2104 SE 14th St",
            "city": "Bentonville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727126902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2020; 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.