Provider Demographics
NPI:1487744405
Name:WHITFIELD, VERMETTA MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:VERMETTA
Middle Name:MARIE
Last Name:WHITFIELD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 NE 52ND ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-7342
Mailing Address - Country:US
Mailing Address - Phone:580-458-2790
Mailing Address - Fax:580-458-2769
Practice Address - Street 1:4301 MOWWAY ROAD
Practice Address - Street 2:REYNOLDS ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-6300
Practice Address - Country:US
Practice Address - Phone:580-458-2134
Practice Address - Fax:580-458-2314
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34012104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker