Provider Demographics
NPI:1316072648
Name:WHITMAN, MARY J (LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:J
Last Name:WHITMAN
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 1:777 S WADSWORTH BLVD
Mailing Address - Street 2:#1-203
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4300
Mailing Address - Country:US
Mailing Address - Phone:303-986-6164
Mailing Address - Fax:720-962-4800
Practice Address - Street 1:777 S WADSWORTH BLVD
Practice Address - Street 2:#1203
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4300
Practice Address - Country:US
Practice Address - Phone:303-986-6164
Practice Address - Fax:720-962-4800
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9892111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical