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General NPI Number Information
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NPI Number | 1831875624
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Entity Type | Individual
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Provider Name | EBONY WHITE LPC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 765 ROUTE 70 E BLDG A
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City | MARLTON
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State | NJ
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Zip | 08053-2341
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Country | US
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Telephone | 856-797-4771
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Fax | 856-797-4785
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Provider Business Mailing Address
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Address Line | 765 ROUTE 70 E BLDG A
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City | MARLTON
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State | NJ
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Zip | 08053-2341
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Country | US
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Telephone | 856-797-4771
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Fax | 856-797-4785
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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 | 37AC00513400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 37AC00513400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC01098300
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License Number State | NJ
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