Provider Demographics
NPI:1003509456
Name:WHITTEMORE, KATHERINE P (LCPC-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:P
Last Name:WHITTEMORE
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-4908
Mailing Address - Country:US
Mailing Address - Phone:207-242-0443
Mailing Address - Fax:
Practice Address - Street 1:1050 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3300
Practice Address - Country:US
Practice Address - Phone:207-242-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health