Provider Demographics
NPI:1770895633
Name:WHITNEY, TIMOTHY W (LCMHC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:W
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 MATHER RD
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-8831
Mailing Address - Country:US
Mailing Address - Phone:802-451-9427
Mailing Address - Fax:
Practice Address - Street 1:176 MATHER RD
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-8831
Practice Address - Country:US
Practice Address - Phone:802-451-9427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health