Provider Demographics
NPI:1336486778
Name:WHITE, WILLIAM CAMPBELL (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CAMPBELL
Last Name:WHITE
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2743 CALIFORNIA AVE SW UNIT 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2495
Mailing Address - Country:US
Mailing Address - Phone:206-304-6297
Mailing Address - Fax:
Practice Address - Street 1:2743 CALIFORNIA AVE SW UNIT 301
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-2495
Practice Address - Country:US
Practice Address - Phone:206-304-6297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2020-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60230157101YM0800X
WALH60406535101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health