Healthcare Provider Details

I. General information

NPI: 1366403354
Provider Name (Legal Business Name): NANETTE CHRISTOPHER WHITE LPCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NANETTE CHRISTOPHER LPCS

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 05/27/2024
Certification Date: 05/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 MOCKINGBIRD ST
NAVASOTA TX
77868-3056
US

IV. Provider business mailing address

806 MOCKINGBIRD ST
NAVASOTA TX
77868-3056
US

V. Phone/Fax

Practice location:
  • Phone: 979-289-1100
  • Fax: 979-289-1108
Mailing address:
  • Phone: 210-845-2525
  • Fax: 979-289-1108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number16468
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: