Provider Demographics
NPI:1184350290
Name:THE WHOLE CHILD, INC.
Entity type:Organization
Organization Name:THE WHOLE CHILD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:DELONGCHAMP
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, MMFT
Authorized Official - Phone:508-603-1711
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:UPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01568-0400
Mailing Address - Country:US
Mailing Address - Phone:508-603-1711
Mailing Address - Fax:
Practice Address - Street 1:2 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:UPTON
Practice Address - State:MA
Practice Address - Zip Code:01568-1655
Practice Address - Country:US
Practice Address - Phone:508-603-1711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA313755OtherSOCIAL WORK LICENSE