Provider Demographics
NPI:1467937581
Name:WHITE, JOSHUA ADAM
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:ADAM
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 1:5130 E SPRING DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-4934
Mailing Address - Country:US
Mailing Address - Phone:317-762-5653
Mailing Address - Fax:
Practice Address - Street 1:5130 E SPRING DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-4934
Practice Address - Country:US
Practice Address - Phone:317-762-5653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor