Provider Demographics
NPI:1275163545
Name:WHITMER, ANNA M (MS, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:M
Last Name:WHITMER
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 S GENOA ST
Mailing Address - Street 2:
Mailing Address - City:GENOA
Mailing Address - State:IL
Mailing Address - Zip Code:60135-1127
Mailing Address - Country:US
Mailing Address - Phone:847-312-0656
Mailing Address - Fax:
Practice Address - Street 1:12555 FARM HILL DR
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-7723
Practice Address - Country:US
Practice Address - Phone:224-650-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-24
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006264101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional