Provider Demographics
NPI:1346597341
Name:WHITE, DELORES EVENS (LPC)
Entity Type:Individual
Prefix:
First Name:DELORES
Middle Name:EVENS
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 N LAURENT ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2147
Mailing Address - Country:US
Mailing Address - Phone:361-572-0202
Mailing Address - Fax:361-572-0300
Practice Address - Street 1:4702 N LAURENT ST
Practice Address - Street 2:SUITE D
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2147
Practice Address - Country:US
Practice Address - Phone:361-572-0202
Practice Address - Fax:361-572-0300
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2023-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66862101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional