Provider Demographics
NPI:1265738686
Name:WHITEMAN, THOMAS HOWLAND JR (PCC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:HOWLAND
Last Name:WHITEMAN
Suffix:JR
Gender:M
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 WINDBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-5047
Mailing Address - Country:US
Mailing Address - Phone:614-428-6145
Mailing Address - Fax:
Practice Address - Street 1:1015 WINDBOURNE ST
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-5047
Practice Address - Country:US
Practice Address - Phone:614-216-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YP1600X
OHE7070101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral