Provider Demographics
NPI:1083382527
Name:WHITE, CAARNE L
Entity Type:Individual
Prefix:DR
First Name:CAARNE
Middle Name:L
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CAARNE
Other - Middle Name:L
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC
Mailing Address - Street 1:1509 CULPEPPER LN
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-6897
Mailing Address - Country:US
Mailing Address - Phone:678-855-5468
Mailing Address - Fax:
Practice Address - Street 1:804 PAVILION CT
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-6666
Practice Address - Country:US
Practice Address - Phone:678-814-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2208098101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty