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NPI Code Detail

MEDICARE: CATHERINE WHITE LPC, BC-DMT

MEDICARE: CATHERINE WHITE LPC, BC-DMT
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
1101YP2500XProfessional CounselorPC009780PA

General Provider Information

NPI Number : 1578120333
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE WHITE LPC, BC-DMT
Provider Business Mailing Address
First Line : 2535 GAUL ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-3129
Country : US
Telephone Number : 919-451-1762
Fax Number :
Provider Business Practice Location Address
First Line : 2566 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-1743
Country : US
Telephone Number : 919-451-1762
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2019
Last Update Date : 05/28/2019

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