Provider Demographics
NPI:1952643660
Name:WHITMYER, MARY ALLISON (LISW)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ALLISON
Last Name:WHITMYER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5212A KINGS MILLS RD STE 128
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-2319
Mailing Address - Country:US
Mailing Address - Phone:513-935-0419
Mailing Address - Fax:
Practice Address - Street 1:5212A KINGS MILLS RD STE 128
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2319
Practice Address - Country:US
Practice Address - Phone:513-935-0419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13035941041C0700X
OHI 16002281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical