Healthcare Provider Details

I. General information

NPI: 1043461262
Provider Name (Legal Business Name): FRANCES HORTON WHITE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N CONGRESS ST SUITE 100
JACKSON MS
39201-1902
US

IV. Provider business mailing address

200 N CONGRESS ST SUITE 100
JACKSON MS
39201-1902
US

V. Phone/Fax

Practice location:
  • Phone: 601-355-8634
  • Fax:
Mailing address:
  • Phone: 601-355-8634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1120
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: