Provider Demographics
NPI:1518001080
Name:WHITMORE, ANITA CESTELLO (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:CESTELLO
Last Name:WHITMORE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-4141
Mailing Address - Country:US
Mailing Address - Phone:706-647-4513
Mailing Address - Fax:706-647-7229
Practice Address - Street 1:615 S CENTER ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-4141
Practice Address - Country:US
Practice Address - Phone:706-647-4513
Practice Address - Fax:706-647-7229
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA LPC 002432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional