Whitehead, Alwyn S.

Whitehead, Alwyn S. is an sole proprietor health care provider with primary practice located at 6920 Bancroft Ave , Saint Louis MO 63109-1902. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Whitehead, Alwyn S. can be contacted via phone (417) 234-1670.

Contact Information

Primary practice address
6920 Bancroft Ave Saint Louis MO 63109-1902
Phone: (417) 234-1670
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2002011127 Missouri
Behavioral Health & Social Service Providers / Forensic 103TF0200X 2002011127 Missouri
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2002011127 Missouri

Profile Details

NPI number 1922212604
LBN Legal business name Whitehead, Alwyn S.
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 10th, 2007
Last updated Apr 22nd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922212604 NPPES
Missouri Other 43-1804357 TAX ID

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