Provider Demographics
NPI:1558014258
Name:WHITMAN, JANE MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:MARIE
Last Name:WHITMAN
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 1:2705 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-3309
Mailing Address - Country:US
Mailing Address - Phone:234-360-3005
Mailing Address - Fax:234-425-5629
Practice Address - Street 1:2705 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-3309
Practice Address - Country:US
Practice Address - Phone:234-360-3005
Practice Address - Fax:234-425-5629
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2203982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty