Provider Demographics
NPI:1316153422
Name:WHITCUP, JOANNA G (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:G
Last Name:WHITCUP
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 GREENWICH AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-6530
Mailing Address - Country:US
Mailing Address - Phone:203-661-7227
Mailing Address - Fax:203-299-0545
Practice Address - Street 1:270 GREENWICH AVE
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6530
Practice Address - Country:US
Practice Address - Phone:203-661-7227
Practice Address - Fax:203-299-0545
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000226106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist