Provider Demographics
NPI:1134405053
Name:WHITE, LINDA A (LCPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 784
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843
Mailing Address - Country:US
Mailing Address - Phone:410-849-7064
Mailing Address - Fax:
Practice Address - Street 1:21 ELM ST
Practice Address - Street 2:SUITE 403
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1902
Practice Address - Country:US
Practice Address - Phone:410-849-7064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4279101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional