Provider Demographics
NPI:1407349582
Name:WHITE, ALLISON (LCSW, LISW-CP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 RESEARCH DR STE 133
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8569
Mailing Address - Country:US
Mailing Address - Phone:980-209-3222
Mailing Address - Fax:844-841-1302
Practice Address - Street 1:9700 RESEARCH DR STE 133
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8569
Practice Address - Country:US
Practice Address - Phone:980-209-3222
Practice Address - Fax:844-841-1302
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC123381041C0700X
NCC0105791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical