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General NPI Number Information
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NPI Number | 1184959975
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Entity Type | Organization
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Legal Business Name | SUE WHITE LCSW,CAP,P.A.
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Dates
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Enumeration Date | 10/12/2009
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Last Update Date | 10/12/2009
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Provider Practice Location Address
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Address Line | 1450 MADRUGA AVE STE 304
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City | CORAL GABLES
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State | FL
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Zip | 33146-3164
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Country | US
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Telephone | 305-663-9080
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Fax | 305-663-1084
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Provider Business Mailing Address
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Address Line | 1450 MADRUGA AVE STE 304
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City | CORAL GABLES
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State | FL
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Zip | 33146-3164
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Country | US
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Telephone | 305-663-9080
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Fax | 305-663-1084
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SUE WHITE
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Credential | LCSW,CAP
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Telephone | 305-663-9080
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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 | SW5462
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License Number State | FL
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