Doctor Name: | COLLEEN ELLEN PHILLIPS-WHITE |
NPI Number: | 1063766400 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S.W. |
License Number: | 007680 |
Business Practice Address: | 401 West Thames St, Bldg 301 Southeastern Mental Health Authority Norwich, CT - 06360 |
Business Phone Number: | 8608594629 |
Business Fax Number: | 8608594725 |
Mailing Address: | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority NORWICH |
State: | CT |
Postal Code: | 06360 |
Phone Number: | 8608594629 |
Fax Number: | 8608594725 |
NPI Enumeration Date: | 11/07/2012 |
NPI Last Update Date: | 11/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 007680 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |