Provider Demographics
NPI:1801210646
Name:WHISENHUNT, MAURA (LISW-S)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:
Last Name:WHISENHUNT
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 HARSHMAN RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-5019
Mailing Address - Country:US
Mailing Address - Phone:937-237-4265
Mailing Address - Fax:
Practice Address - Street 1:1801 HARSHMAN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-5019
Practice Address - Country:US
Practice Address - Phone:937-237-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI5991OtherINDEPENDENT SOCIAL WORK LICENSE