Provider Demographics
NPI:1669002325
Name:WHITE, BRIAN D (MRC, LPC, CRC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:WHITE
Suffix:
Gender:M
Credentials:MRC, LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9859 CHAPEL TRL
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-7640
Mailing Address - Country:US
Mailing Address - Phone:214-300-9349
Mailing Address - Fax:
Practice Address - Street 1:3900 S STONEBRIDGE DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7899
Practice Address - Country:US
Practice Address - Phone:214-300-9349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72233101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor