Provider Demographics
NPI:1578609343
Name:WHITCOMB, SANDRA (ED D LMHC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:WHITCOMB
Suffix:
Gender:F
Credentials:ED D LMHC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:JOHNSTON
Other - Last Name:WHITCOMB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12 O NEIL RD
Mailing Address - Street 2:
Mailing Address - City:HAYDENVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01039
Mailing Address - Country:US
Mailing Address - Phone:413-268-0059
Mailing Address - Fax:
Practice Address - Street 1:48 N PLEASANT ST SUITE 206
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002
Practice Address - Country:US
Practice Address - Phone:413-256-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC #3008101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor