Provider Demographics
NPI:1477884328
Name:WHITE, KERSTIN ELISABETH (LPC)
Entity Type:Individual
Prefix:MS
First Name:KERSTIN
Middle Name:ELISABETH
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 1:34 VINTON RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-2506
Mailing Address - Country:US
Mailing Address - Phone:973-462-4826
Mailing Address - Fax:
Practice Address - Street 1:19 GREEN AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2521
Practice Address - Country:US
Practice Address - Phone:973-462-4826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00382400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional