Provider Demographics
NPI:1902839756
Name:WHITE, WILLIAM PHILLIP (LCSW, MSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PHILLIP
Last Name:WHITE
Suffix:
Gender:M
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4608
Mailing Address - Country:US
Mailing Address - Phone:918-269-9976
Mailing Address - Fax:918-269-9976
Practice Address - Street 1:1711 E 15TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4608
Practice Address - Country:US
Practice Address - Phone:918-269-9976
Practice Address - Fax:918-269-9976
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical