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General NPI Number Information
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NPI Number | 1801294186
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Entity Type | Individual
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Provider Name | MARIETTA H. WHITTLESEY M.S. L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 12/18/2014
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 6 NEW ST
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City | SHARON
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State | CT
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Zip | 06069-2077
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Country | US
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Telephone | 518-398-9637
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 125
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City | ANCRAMDALE
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State | NY
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Zip | 12503-0125
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Country | US
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Telephone | 518-398-9637
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2678
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License Number State | CT
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