Max Duane Whipple III, SUDP, AAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

101YA0400X Issued in WA

Practice address

1155 N State St Ste 522
Bellingham, WA 98225-5045

Phone

(360) 676-4485

NPI assigned

Sep 6, 2018

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Illahee Home Corp

  • Addiction (Substance Use Disorder) Counselor
  • Bellingham, WA
  • NPI 1124329669
  NPD
• Illahee Home Corp

  • Counselor
  • Bellingham, WA
  • NPI 1265982763
  NPD (past)

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1760964696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N STATE ST STE 522",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255045",
            "telephone_number": "360-676-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N STATE ST STE 522",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255045",
            "telephone_number": "360-676-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHIPPLE",
        "first_name": "MAX",
        "middle_name": "DUANE",
        "name_suffix": "III",
        "credential": "SUDP, AAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-06",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CP61158216",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "101YA0400X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2238136",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON DEPARTMENT OF HEALTH",
            "identifier": "CO60880131",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meagan Wheeler
• Travis Wheeler, LMT
• Charles D Whelan III, PA-C
• Whiplash and Injury Clinic PLLC
• John Whipple, B.A.
• Nicole Joann Whipple, OTRL
• Heather Whitaker, FNP
• Celeste White
• Christopher Nils White, M.A.
• Emily Rose Laraine White

• Addiction (Substance Use Disorder) Counselor in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.