MEDICARE: CARRIE WHIPPLE

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1790585446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE WHIPPLE

Provider Business Mailing Address
First Line	:	4 ELIOT AVE
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12203-2612
Country	:	US
Telephone Number	:	315-657-2330
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 206TH ST
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11360-2337
Country	:	US
Telephone Number	:	516-855-8255
Fax Number	:

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

Provider Enumeration Date	:	03/13/2025
Last Update Date	:	03/13/2025

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Directions to “ CARRIE WHIPPLE ” Practice Location

Language	Start Address	Practice Location

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