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General NPI Number Information
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NPI Number | 1104687482
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Entity Type | Organization
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Legal Business Name | JAY WHITE COUNSELING LLC
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 811 E WASHINGTON AVE FL 4
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City | MADISON
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State | WI
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Zip | 53703-3688
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Country | US
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Telephone | 608-469-1417
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Fax |
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Provider Business Mailing Address
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Address Line | 701 W OLIN AVE
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City | MADISON
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State | WI
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Zip | 53715-2139
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Country | US
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Telephone | 608-469-1417
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN W WHITE JR.
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Credential | MSW
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Telephone | 608-469-1417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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