Doctor Name: | MS. KATHERINE LORRAINE WHITE |
NPI Number: | 1134477243 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 9472 |
Business Practice Address: | 1290 Tremont St Roxbury, MA - 021203432 |
Business Phone Number: | 6179893080 |
Business Fax Number: | |
Mailing Address: | 16 Winfield St, Apt #3 SOUTH BOSTON |
State: | MA |
Postal Code: | 021274126 |
Phone Number: | 7865467310 |
Fax Number: | |
NPI Enumeration Date: | 08/21/2012 |
NPI Last Update Date: | 03/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 9472 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |