Healthcare Provider Details

I. General information

NPI: 1700592680
Provider Name (Legal Business Name): JOHN ASTON WHITE LCMHC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 MORGANTON BLVD SW
LENOIR NC
28645-9691
US

IV. Provider business mailing address

716 DON HAYES RD
BOONE NC
28607-8143
US

V. Phone/Fax

Practice location:
  • Phone: 828-394-5563
  • Fax:
Mailing address:
  • Phone: 828-773-1481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCMHC-A
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: