Provider Demographics
NPI:1932291671
Name:WHITE, DAN (MSW)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 SPRING CREEK RD
Mailing Address - Street 2:APT 154
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412
Mailing Address - Country:US
Mailing Address - Phone:423-364-6635
Mailing Address - Fax:
Practice Address - Street 1:150 DEBRA LANE
Practice Address - Street 2:SUITE 5200,BLDG 6300;EASTGATE CTR.
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411
Practice Address - Country:US
Practice Address - Phone:423-893-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45084101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical