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General NPI Number Information
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NPI Number | 1225420474
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Entity Type | Individual
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Provider Name | ROBERT LANON WHITE LCMHC-S
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Gender | Male
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Dates
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Enumeration Date | 02/25/2015
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 245 MOREELL AVE
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City | GULFPORT
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State | MS
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Zip | 39501-5674
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Country | US
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Telephone | 228-871-3452
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Fax | 228-871-3452
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Provider Business Mailing Address
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Address Line | 145 SCALEYBARK RD
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City | CHARLOTTE
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State | NC
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Zip | 28209-2687
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Country | US
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Telephone | 704-567-8690
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701014867
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | S11175
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License Number State | NC
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