Basic Information
Provider Information
NPI: 1316286818
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BINETTE
FirstName: WHITNEY
MiddleName: L.
NamePrefix:  
NameSuffix:  
Credential: LCPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LAMB
OtherFirstName: WHITNEY
OtherMiddleName: L.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 78 ATLANTIC PL
Address2:  
City: SOUTH PORTLAND
State: ME
PostalCode: 041062316
CountryCode: US
TelephoneNumber: 2076616654
FaxNumber: 2078427773
Practice Location
Address1: 474 MAIN ST
Address2:  
City: SPRINGVALE
State: ME
PostalCode: 040831409
CountryCode: US
TelephoneNumber: 2073241500
FaxNumber: 2074905263
Other Information
ProviderEnumerationDate: 02/05/2013
LastUpdateDate: 03/17/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XCC4439MEY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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