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General NPI Number Information
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NPI Number | 1528570868
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Entity Type | Organization
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Legal Business Name | WHITE OAK COUNSELING, INC.
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 103 S PANTOPS DR STE 203
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-8617
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Country | US
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Telephone | 773-320-2907
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Fax |
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Provider Business Mailing Address
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Address Line | 103 S PANTOPS DR STE 203
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-8617
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OR CLINICAL OPERATIONS
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Name | CARLY MOUNT
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Credential | PSY.D.
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Telephone | 773-320-2907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810005487
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License Number State | VA
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