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NPI Code Detail

MEDICARE: KENIA WHITE LMSW, LCSWA

MEDICARE: KENIA WHITE LMSW, LCSWA
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
1104100000XSocial WorkerLSW0000013027TN

General Provider Information

NPI Number : 1164200937
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENIA WHITE LMSW, LCSWA
Provider Business Mailing Address
First Line : 1021 EXECUTIVE DR
Second Line :
City : HIXSON
State : TN
Zip : 37343-7918
Country : US
Telephone Number : 423-531-3398
Fax Number :
Provider Business Practice Location Address
First Line : 9219 LEE HWY STE 103
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-4440
Country : US
Telephone Number : 423-531-3398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2023
Last Update Date : 09/21/2023

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Directions to “ KENIA WHITE LMSW, LCSWA” Practice Location

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