Provider Demographics
NPI:1689258881
Name:WHITE, DONNA LAVONN (LCDC)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LAVONN
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8234 ALMERA FALLS DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2872
Mailing Address - Country:US
Mailing Address - Phone:346-332-8997
Mailing Address - Fax:
Practice Address - Street 1:8234 ALMERA FALLS DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2872
Practice Address - Country:US
Practice Address - Phone:346-332-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9422101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty