Provider Demographics
NPI:1790085249
Name:WHIPPLE, MARY BRENT (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:BRENT
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N. DUPONT RD.
Mailing Address - Street 2:WILMINGTON CAMPUS CNTR.
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807
Mailing Address - Country:US
Mailing Address - Phone:302-651-2100
Mailing Address - Fax:302-651-2111
Practice Address - Street 1:100 N DUPONT RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807
Practice Address - Country:US
Practice Address - Phone:302-651-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00001641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical