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General NPI Number Information
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NPI Number | 1023592243
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Entity Type | Individual
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Provider Name | KEYONI RATES WHITE LPCC-S
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Gender | Female
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Dates
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Enumeration Date | 09/24/2018
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Last Update Date | 11/16/2024
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Provider Practice Location Address
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Address Line | 11401 LORAIN AVE
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City | CLEVELAND
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State | OH
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Zip | 44111-5476
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Country | US
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Telephone | 216-416-4277
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Fax |
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Provider Business Mailing Address
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Address Line | 1215 W 10TH ST APT 817
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City | CLEVELAND
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State | OH
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Zip | 44113-1283
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Country | US
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Telephone | 216-512-1490
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.2102328-SUPV
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License Number State | OH
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