Provider Demographics
NPI:1710556386
Name:WHITMER, SAMANTHA M (CDCA II)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:M
Last Name:WHITMER
Suffix:
Gender:F
Credentials:CDCA II
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:721 LINCOLN WAY E
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-6829
Mailing Address - Country:US
Mailing Address - Phone:844-347-0543
Mailing Address - Fax:330-409-9081
Practice Address - Street 1:721 LINCOLN WAY E
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-6829
Practice Address - Country:US
Practice Address - Phone:844-347-0543
Practice Address - Fax:330-409-9081
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.162816101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCDCA.162816OtherCDCA