Provider Demographics
NPI:1720244569
Name:WHIPPLE, KEITH LORIN (MA)
Entity Type:Individual
Prefix:MR
First Name:KEITH
Middle Name:LORIN
Last Name:WHIPPLE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 DEMPSTER ST
Mailing Address - Street 2:INSTITUTE FOR THERAPY THROUGH THE ARTS
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1017
Mailing Address - Country:US
Mailing Address - Phone:847-448-8346
Mailing Address - Fax:847-425-9728
Practice Address - Street 1:2008 DEMPSTER ST
Practice Address - Street 2:INSTITUTE FOR THERAPY THROUGH THE ARTS
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1017
Practice Address - Country:US
Practice Address - Phone:847-448-8346
Practice Address - Fax:847-425-9728
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor