MEDICARE: MRS. JENNIFER L WHIPPLE LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	114815	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	003145301	OTHER	MA	MEDICARE PTAN

General Provider Information

NPI Number	:	1336363183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER L WHIPPLE LICSW

Provider Business Mailing Address
First Line	:	4 WINDSOR DR
Second Line	:
City	:	ASHLAND
State	:	MA
Zip	:	01721-2008
Country	:	US
Telephone Number	:	617-283-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 WINDSOR DR
Second Line	:
City	:	ASHLAND
State	:	MA
Zip	:	01721-2008
Country	:	US
Telephone Number	:	617-283-0002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	03/14/2022

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