Provider Demographics
NPI:1417513276
Name:WHITTEMORE, CASEY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:
Last Name:WHITTEMORE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:AMBER
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6877
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93006-6877
Mailing Address - Country:US
Mailing Address - Phone:805-232-3490
Mailing Address - Fax:
Practice Address - Street 1:1500 PALMA DR FL 2
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6451
Practice Address - Country:US
Practice Address - Phone:805-232-3490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-16
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA134133101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health