Provider Demographics
NPI:1306000419
Name:WHITE, JOHN HUBERT JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HUBERT
Last Name:WHITE
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-2116
Mailing Address - Country:US
Mailing Address - Phone:609-226-3202
Mailing Address - Fax:609-748-2212
Practice Address - Street 1:11 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:ABSECON
Practice Address - State:NJ
Practice Address - Zip Code:08201-2116
Practice Address - Country:US
Practice Address - Phone:609-226-3202
Practice Address - Fax:609-748-2212
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00399900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical