Provider Demographics
NPI:1427327915
Name:WHITTET, DEEANN LEA (LCSW-R)
Entity type:Individual
Prefix:
First Name:DEEANN
Middle Name:LEA
Last Name:WHITTET
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6072 STATE FARM RD
Mailing Address - Street 2:FARNSWORTH MIDDLE SCHOOL
Mailing Address - City:GUILDERLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12084-9532
Mailing Address - Country:US
Mailing Address - Phone:518-456-6010
Mailing Address - Fax:518-456-3747
Practice Address - Street 1:6072 STATE FARM RD
Practice Address - Street 2:FARNSWORTH MIDDLE SCHOOL
Practice Address - City:GUILDERLAND
Practice Address - State:NY
Practice Address - Zip Code:12084-9532
Practice Address - Country:US
Practice Address - Phone:518-456-6010
Practice Address - Fax:518-456-3747
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0640181041C0700X
NY6638740611041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool