Doctor Name: | MR. CODY WHITE |
NPI Number: | 1275990012 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | 178008867 |
Business Practice Address: | 5825 W Belmont Ave Chicago, IL - 606345203 |
Business Phone Number: | 7736370487 |
Business Fax Number: | 7736371740 |
Mailing Address: | 5825 W Belmont Ave, CHICAGO |
State: | IL |
Postal Code: | 606345203 |
Phone Number: | 7736370487 |
Fax Number: | 7736371740 |
NPI Enumeration Date: | 01/25/2016 |
NPI Last Update Date: | 01/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 178008867 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |