Provider Demographics
NPI:1184042178
Name:WHITE, HAROLD (LCDCI)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:LCDCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 DURHAM DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5409
Mailing Address - Country:US
Mailing Address - Phone:713-636-9138
Mailing Address - Fax:281-888-6510
Practice Address - Street 1:1213 DURHAM DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5409
Practice Address - Country:US
Practice Address - Phone:713-636-9138
Practice Address - Fax:281-888-6510
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10892101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)