Provider Demographics
NPI:1952653065
Name:N. WILLIAM WHITE LCSW LADC
Entity Type:Organization
Organization Name:N. WILLIAM WHITE LCSW LADC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DA, LCSW, MLADC
Authorized Official - Phone:603-986-6051
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NH
Mailing Address - Zip Code:03846
Mailing Address - Country:US
Mailing Address - Phone:603-986-6051
Mailing Address - Fax:
Practice Address - Street 1:30 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818
Practice Address - Country:US
Practice Address - Phone:603-447-3329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH284251S00000X
MELC00006034251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health