MEDICARE: JOYCELYN WHITE LPC

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	101YP2500X	Professional Counselor	LPC015137	GA

General Provider Information

NPI Number	:	1902633548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCELYN WHITE LPC

Provider Business Mailing Address
First Line	:	6180 PEAKE RD
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31220-3956
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6180 PEAKE RD
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31220-3956
Country	:	US
Telephone Number	:	478-335-4706
Fax Number	:

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

Provider Enumeration Date	:	09/17/2024
Last Update Date	:	09/17/2024

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Directions to “ JOYCELYN WHITE LPC” Practice Location

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