MEDICARE: WILLIAM C WHITE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1104267723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM C WHITE

Provider Business Mailing Address
First Line	:	105 SE 45TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73129-3201
Country	:	US
Telephone Number	:	405-632-1900
Fax Number	:	405-632-1976

Provider Business Practice Location Address
First Line	:	1400 SE 4TH ST STE A
Second Line	:
City	:	MOORE
State	:	OK
Zip	:	73160-7328
Country	:	US
Telephone Number	:	720-352-2557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2013
Last Update Date	:	12/24/2025

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Directions to “ WILLIAM C WHITE ” Practice Location

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