Provider Demographics
NPI:1952498321
Name:WHITE, VICTOR (LPC, LAC, CCS)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:LPC, LAC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 REED AVE
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-3238
Mailing Address - Country:US
Mailing Address - Phone:318-730-9757
Mailing Address - Fax:
Practice Address - Street 1:2907 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-4332
Practice Address - Country:US
Practice Address - Phone:318-730-9757
Practice Address - Fax:337-602-1382
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA151171M00000X
LA965101YA0400X
LA7146101YP2500X
LAPLC7146171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)