Provider Demographics
NPI:1346694460
Name:WHITE, SEAN DUPREE
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:DUPREE
Last Name:WHITE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 CLAREMONT PKWY
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-8346
Mailing Address - Country:US
Mailing Address - Phone:917-674-2918
Mailing Address - Fax:
Practice Address - Street 1:551 CLAREMONT PKWY
Practice Address - Street 2:FLOOR 1
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8346
Practice Address - Country:US
Practice Address - Phone:917-674-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097148-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker