Provider Demographics
NPI:1134636657
Name:WHITE, ALYSSA J (LMHP, CMSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:J
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMHP, CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 DODGE ST.
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-1963
Mailing Address - Country:US
Mailing Address - Phone:402-955-4082
Mailing Address - Fax:888-972-5038
Practice Address - Street 1:8200 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:402-955-4082
Practice Address - Fax:888-972-5038
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5489101YM0800X
KS9653104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker