Provider Demographics
NPI:1265059752
Name:MAROCCO, WHITNEY LEA (LCSW)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LEA
Last Name:MAROCCO
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 1:1217 N DEQUINCY ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46201-1821
Mailing Address - Country:US
Mailing Address - Phone:812-391-6172
Mailing Address - Fax:
Practice Address - Street 1:120 E MARKET ST STE 721
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-3237
Practice Address - Country:US
Practice Address - Phone:317-279-6585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008832A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty