| Doctor Name: | MICHAEL WHITWELL |
| NPI Number: | 1003185612 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCDC |
| License Number: | 3524 |
| Business Practice Address: | 950 N 4th St Longview, TX - 756015436 |
| Business Phone Number: | 9037580596 |
| Business Fax Number: | |
| Mailing Address: | Po Box 6800, LONGVIEW |
| State: | TX |
| Postal Code: | 756086800 |
| Phone Number: | 9037582471 |
| Fax Number: | |
| NPI Enumeration Date: | 12/28/2011 |
| NPI Last Update Date: | 12/28/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 3524 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |