Healthcare Provider Details

I. General information

NPI: 1881793545
Provider Name (Legal Business Name): LEON E. WHITTEMORE JR. L.M.H.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

288 BEDFORD ST
WHITMAN MA
02382-1820
US

IV. Provider business mailing address

1 WILLOW ST
KINGSTON MA
02364-1550
US

V. Phone/Fax

Practice location:
  • Phone: 781-718-4492
  • Fax: 781-447-1786
Mailing address:
  • Phone: 508-747-6302
  • Fax: 508-747-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5082
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: