Provider Demographics
NPI:1417036567
Name:WHIPPLE, DONNA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1641
Mailing Address - Country:US
Mailing Address - Phone:978-682-5627
Mailing Address - Fax:
Practice Address - Street 1:324 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-1329
Practice Address - Country:US
Practice Address - Phone:978-664-2566
Practice Address - Fax:978-664-8023
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7144103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1898213Medicaid
MA007144OtherTUFTS HEALTH PLAN
MAW05593OtherBCBS FEDERAL
MA043114833-04OtherPACIFICARE BEHAVIORAL HEA
MA1028943OtherCIGNA BEHAVIORAL HEALTH
MA002599OtherVALUE OPTIONS
MA007144OtherTUFTS BENEFIT ADMINISTRAT
MAW05593OtherBCBS OF MA
MAW05593OtherMEDEX
MAW50320Medicare ID - Type UnspecifiedMEDICARE