MEDICARE: PATRICE WHETSEL

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
2	1041C0700X	Clinical Social Worker	I.1700583-SUPV	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437718079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICE WHETSEL

Provider Business Mailing Address
First Line	:	433 W MADISON ST
Second Line	:
City	:	GIBSONBURG
State	:	OH
Zip	:	43431-1220
Country	:	US
Telephone Number	:	567-207-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	7318 INTERNATIONAL DR
Second Line	:
City	:	HOLLAND
State	:	OH
Zip	:	43528-9560
Country	:	US
Telephone Number	:	419-318-1496
Fax Number	:	567-249-0043

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

Provider Enumeration Date	:	06/07/2019
Last Update Date	:	01/26/2026

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Directions to “ PATRICE WHETSEL ” Practice Location

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