Healthcare Provider Details

I. General information

NPI: 1225705197
Provider Name (Legal Business Name): NANCY LEE WHITE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2934 KEMP BLVD
WICHITA FALLS TX
76308-1017
US

IV. Provider business mailing address

PO BOX 9597
WICHITA FALLS TX
76308-9597
US

V. Phone/Fax

Practice location:
  • Phone: 940-691-1899
  • Fax: 940-691-3423
Mailing address:
  • Phone: 940-322-9309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number82642
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number82642
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: