Provider Demographics
NPI:1619314911
Name:WHITNEY, JOSHUA LUCAS
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:LUCAS
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 SOUTHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1940
Mailing Address - Country:US
Mailing Address - Phone:774-270-4073
Mailing Address - Fax:
Practice Address - Street 1:169 SOUTHVILLE RD
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-1940
Practice Address - Country:US
Practice Address - Phone:774-270-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health