Healthcare Provider Details

I. General information

NPI: 1134118201
Provider Name (Legal Business Name): SEAN WHIPPLE WITHINGTON L.I.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 COURT ST
PLYMOUTH MA
02360-4334
US

IV. Provider business mailing address

1 MASSASOIT ST
PLYMOUTH MA
02360-3407
US

V. Phone/Fax

Practice location:
  • Phone: 508-667-6704
  • Fax: 508-747-7470
Mailing address:
  • Phone: 508-667-6704
  • Fax: 508-747-7470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1763
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1025981
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: