Provider Demographics
NPI:1144247669
Name:WHITMER, GARY E (LCSW)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:E
Last Name:WHITMER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:282 PLEASANT DR
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1321
Mailing Address - Country:US
Mailing Address - Phone:925-980-8632
Mailing Address - Fax:800-242-5103
Practice Address - Street 1:2934 VICTORIA MEADOW CT
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6317
Practice Address - Country:US
Practice Address - Phone:510-548-0680
Practice Address - Fax:800-242-5103
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 64311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-3224873OtherEMPLOYER TAX ID