Provider Demographics
NPI:1073641528
Name:WHITE, NORMA S (RN, LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:S
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 VISTA CENTRE DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2600
Mailing Address - Country:US
Mailing Address - Phone:434-316-9339
Mailing Address - Fax:434-316-7025
Practice Address - Street 1:110 VISTA CENTRE DR
Practice Address - Street 2:SUITE 5
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-2600
Practice Address - Country:US
Practice Address - Phone:434-316-9339
Practice Address - Fax:434-316-7025
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002466101YM0800X
VA0717000397106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701002466OtherLPC
VA0717000397OtherLMFT