Individual
PHILLIP WHITELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA, PRS
Contact information
Practice address
411 2ND ST, PORTSMOUTH, OH 45662-3806
(740) 354-7545
Mailing address
433 3RD ST, PORTSMOUTH, OH 45662-3811
(740) 716-8746
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
0001602
OH
Other
Enumeration date
10/31/2018
Last updated
02/03/2021
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