Provider Demographics
NPI:1477746709
Name:WHITE, JOY HANSEN (LCPC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:HANSEN
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:WOLF POINT
Mailing Address - State:MT
Mailing Address - Zip Code:59201-1819
Mailing Address - Country:US
Mailing Address - Phone:406-581-3705
Mailing Address - Fax:406-494-1724
Practice Address - Street 1:710 FALLON ST
Practice Address - Street 2:
Practice Address - City:WOLF POINT
Practice Address - State:MT
Practice Address - Zip Code:59201
Practice Address - Country:US
Practice Address - Phone:406-653-3706
Practice Address - Fax:406-494-1724
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1246101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1246OtherSTATE OF MONTANA LICENSE