Provider Demographics
NPI:1568829620
Name:AMY J. WHITE, LCPC & ASSOCIATES PC
Entity Type:Organization
Organization Name:AMY J. WHITE, LCPC & ASSOCIATES PC
Other - Org Name:AMY J. WHITE, LCPC PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-775-9661
Mailing Address - Street 1:2931F OLNEY SANDY SPRING ROAD
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-775-9661
Mailing Address - Fax:301-830-6862
Practice Address - Street 1:2931 OLNEY SANDY SPRING RD STE F
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1579
Practice Address - Country:US
Practice Address - Phone:301-775-9661
Practice Address - Fax:301-830-6862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD499101YA0400X
MDLC2138101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty