Healthcare Provider Details

I. General information

NPI: 1194530527
Provider Name (Legal Business Name): DAN LLEWELLYN WHATLEY LCPC-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 FALMOUTH RD
WINDHAM ME
04062-4590
US

IV. Provider business mailing address

71 FALMOUTH RD
WINDHAM ME
04062-4590
US

V. Phone/Fax

Practice location:
  • Phone: 207-808-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberXL7931
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: