Healthcare Provider Details

I. General information

NPI: 1396654695
Provider Name (Legal Business Name): CAPRICIA K WHITE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 HEATHERWOOD LN
GREER SC
29651-7293
US

IV. Provider business mailing address

119 HEATHERWOOD LN
GREER SC
29651-7293
US

V. Phone/Fax

Practice location:
  • Phone: 843-367-6952
  • Fax:
Mailing address:
  • Phone: 843-367-6952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number283563
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: