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General NPI Number Information
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NPI Number | 1023307600
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Entity Type | Individual
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Provider Name | VIVA L WHITE PHD,MSW,LCSW,LCADC
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Gender | Female
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 790 CLINTON AVE
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City | NEWARK
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State | NJ
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Zip | 07108-1047
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Country | US
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Telephone | 973-517-4488
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Fax | 973-926-3577
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Provider Business Mailing Address
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Address Line | PO BOX 28038
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City | NEWARK
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State | NJ
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Zip | 07101-2482
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Country | US
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Telephone | 862-235-0828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37CA00095300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05454500
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License Number State | NJ
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