Provider Demographics
NPI:1184685760
Name:WHELAN, JANE M (LICSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:M
Last Name:WHELAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 PUBLIC ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-1518
Mailing Address - Country:US
Mailing Address - Phone:508-695-7659
Mailing Address - Fax:401-722-5451
Practice Address - Street 1:100 LAFAYETTE ST
Practice Address - Street 2:SUITE 305
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6008
Practice Address - Country:US
Practice Address - Phone:508-463-7698
Practice Address - Fax:401-722-5451
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW005571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical