Provider Demographics
NPI:1487996260
Name:RICHMAN, WHITNEY
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:
Last Name:RICHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:HAJEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MST, BCBA
Mailing Address - Street 1:4440 N BEACON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-6212
Mailing Address - Country:US
Mailing Address - Phone:804-338-5182
Mailing Address - Fax:
Practice Address - Street 1:4440 N BEACON ST APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-6212
Practice Address - Country:US
Practice Address - Phone:804-338-5182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-13-12935103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst