Provider Demographics
NPI:1225247992
Name:WHITE, SYLVIA THOMAS (LPC-MHSP, RD, LDN)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:THOMAS
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC-MHSP, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 KATE BOND RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-4004
Mailing Address - Country:US
Mailing Address - Phone:901-384-0065
Mailing Address - Fax:901-266-1165
Practice Address - Street 1:3025 KATE BOND RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133
Practice Address - Country:US
Practice Address - Phone:901-384-0065
Practice Address - Fax:901-266-1165
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2182101YM0800X
TNLPC2182101YP2500X
TN508133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
3241269Medicare PIN