Provider Demographics
NPI:1033703699
Name:WHITE, ERIN KENNEDY (LPC-MHSP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:KENNEDY
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:JOELLE
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1043 DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-2902
Mailing Address - Country:US
Mailing Address - Phone:770-617-7017
Mailing Address - Fax:
Practice Address - Street 1:3421 DAYTON BLVD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-4626
Practice Address - Country:US
Practice Address - Phone:423-682-8402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5295101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional