Healthcare Provider Details

I. General information

NPI: 1902605587
Provider Name (Legal Business Name): ERIKA WHITE MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N DIXIE HWY
STUART FL
34994-1114
US

IV. Provider business mailing address

PO BOX 1380
STUART FL
34995-1380
US

V. Phone/Fax

Practice location:
  • Phone: 772-692-4410
  • Fax: 772-692-4508
Mailing address:
  • Phone: 772-692-4410
  • Fax: 772-692-4508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH26937
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: