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NPI Code Detail

MEDICARE: MRS. CAROLYN H. WHITE LCDC

MEDICARE: MRS. CAROLYN H. WHITE LCDC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor10945TX

General Provider Information

NPI Number : 1649515545
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROLYN H. WHITE LCDC
Provider Business Mailing Address
First Line : 8402 CROSS PARK DR
Second Line :
City : AUSTIN
State : TX
Zip : 78754-4595
Country : US
Telephone Number : 512-697-8588
Fax Number : 512-697-8598
Provider Business Practice Location Address
First Line : 8402 CROSS PARK DR
Second Line :
City : AUSTIN
State : TX
Zip : 78754-4595
Country : US
Telephone Number : 512-697-8588
Fax Number : 512-697-8598
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2012
Last Update Date : 12/03/2012

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