Healthcare Provider Details

I. General information

NPI: 1013694900
Provider Name (Legal Business Name): KRISTIN JONES WHITE CADC, ADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 PAVILLON PL
MILL SPRING NC
28756-5809
US

IV. Provider business mailing address

241 PAVILLON PL
MILL SPRING NC
28756-5809
US

V. Phone/Fax

Practice location:
  • Phone: 828-429-5544
  • Fax:
Mailing address:
  • Phone: 828-694-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCADC-21825
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADC-2394
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: