Provider Demographics
NPI:1790081230
Name:WHETSTINE, JANE A (MS, NCC, LCPC-C)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:A
Last Name:WHETSTINE
Suffix:
Gender:F
Credentials:MS, NCC, LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HARPSWELL RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-7842
Mailing Address - Country:US
Mailing Address - Phone:207-504-2800
Mailing Address - Fax:888-371-8099
Practice Address - Street 1:103 HARPSWELL RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-7842
Practice Address - Country:US
Practice Address - Phone:207-504-2800
Practice Address - Fax:888-371-8099
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL3562101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health