Active NPI
Mark Bennett Whitehill, PH.D.
- Clinical Psychologist
- Lakewood, WA
National Provider Identifier
1801002084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY00001200
- Practice address
- 3815 100TH St SW
Suite 2-B
Lakewood, WA 98499-4401 - Phone
- (253) 984-7686
- Fax
- (253) 984-7862
- NPI assigned
- May 15, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | PY00001200 | WA | |
| Clinical Psychologist | 103TC0700X | PY00001200 | WA | Primary |
Addresses
Primary practice location
3815 100TH St SW
Suite 2-B
Lakewood, WA 98499-4401
Mailing address
3815 100TH St SW
Suite 2-B
Lakewood, WA 98499-4401
Phone (253) 984-7686
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
| License | State | Type | Specialty |
|---|---|---|---|
| PY00001200 | WA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clincal & Forensic Psychology, Inc., P.S. | Past | Accepting new patients |
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.
-
- Psychologist
- Lakewood, WA
- NPI 1679696777
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1801002084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3815 100TH ST SW",
"address_2": "SUITE 2-B",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984994401",
"telephone_number": "253-984-7686",
"fax_number": "253-984-7862"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3815 100TH ST SW",
"address_2": "SUITE 2-B",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984994401",
"telephone_number": "253-984-7686",
"fax_number": "253-984-7862"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHILL",
"first_name": "MARK",
"middle_name": "BENNETT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-15",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "WA",
"license": "PY00001200",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00001200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.