| Doctor Name: | MR. CHARLES MARLIN WHITE |
| NPI Number: | 1366761264 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW LCADC |
| License Number: | 37LC00073100 |
| Business Practice Address: | 567 Park Avenue Suite 203 Scotch Plains, NJ - 070761754 |
| Business Phone Number: | 9083220112 |
| Business Fax Number: | 9087890230 |
| Mailing Address: | 567 Park Avenue, Suite 203 SCOTCH PLAINS |
| State: | NJ |
| Postal Code: | 070761754 |
| Phone Number: | 9083220112 |
| Fax Number: | 9087890230 |
| NPI Enumeration Date: | 05/18/2010 |
| NPI Last Update Date: | 06/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 37LC00073100 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |