Mary Jane Whitmore, LCSW, CADCIII

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7186-123 Issued in WI

Practice address

840 Lake Ave
Suite 101
Racine, WI 53403-1566

Phone

(262) 634-8688

Fax

(262) 634-7547

NPI assigned

May 26, 2006

Last updated

Jul 12, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Racine Psychological Services, Inc.

  • Adult Mental Health Clinic/Center
  • Racine, WI
  • NPI 1275586323
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1134175334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 LAKE AVE",
            "address_2": "SUITE 101",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031566",
            "telephone_number": "262-634-8688",
            "fax_number": "262-634-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 LAKE AVE",
            "address_2": "SUITE 101",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031566",
            "telephone_number": "262-634-8688",
            "fax_number": "262-634-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMORE",
        "first_name": "MARY JANE",
        "credential": "LCSW, CADCIII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7186-123",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1623-132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39341100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wheaton Franciscan Healthcare-All Saints, Inc
• Wheaton Franciscan Healthcare-All Saints, Inc.
• Wheaton Franciscan Hospital
• Mary A Wheeler, PA
• Hollie White, APSW
• Alyson Gail Wiedenbeck, CCC-SLP
• Margaret Jean Wiesner, PHARMD
• William A. Wilke, LCSW, SAC
• Kaye-Eileen Willard, MD
• Aleeshia Williams

• Clinical Social Worker in Racine, WI
• Providers in Racine, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.