Provider Demographics
NPI:1285688994
Name:WHINNERY, MICHELE LEE (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:LEE
Last Name:WHINNERY
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:LEE
Other - Last Name:WHINNERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:209 GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTIA
Mailing Address - State:NY
Mailing Address - Zip Code:12302-2126
Mailing Address - Country:US
Mailing Address - Phone:518-231-1906
Mailing Address - Fax:518-355-1573
Practice Address - Street 1:209 GLEN AVE
Practice Address - Street 2:
Practice Address - City:SCOTIA
Practice Address - State:NY
Practice Address - Zip Code:12302-2126
Practice Address - Country:US
Practice Address - Phone:518-231-1906
Practice Address - Fax:518-355-1573
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-048034-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55969BMedicare ID - Type Unspecified