MEDICARE: JOHN ROBERT WHITE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1700109774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ROBERT WHITE

Provider Business Mailing Address
First Line	:	302 S. AIKEN AVE.
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1002
Country	:	US
Telephone Number	:	330-843-3427
Fax Number	:

Provider Business Practice Location Address
First Line	:	6324 MARCHAND ST.
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15204-4312
Country	:	US
Telephone Number	:	412-661-1239
Fax Number	:	412-661-1304

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2010
Last Update Date	:	03/05/2010

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Directions to “ JOHN ROBERT WHITE ” Practice Location

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