Provider Demographics
NPI:1245536580
Name:WHITE, DEANA MCMAHON (MA LPC, CADC-M, LBSW)
Entity type:Individual
Prefix:MRS
First Name:DEANA
Middle Name:MCMAHON
Last Name:WHITE
Suffix:
Gender:F
Credentials:MA LPC, CADC-M, LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-6108
Mailing Address - Country:US
Mailing Address - Phone:248-969-0641
Mailing Address - Fax:248-969-0840
Practice Address - Street 1:1450 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-6108
Practice Address - Country:US
Practice Address - Phone:248-969-0641
Practice Address - Fax:248-969-0840
Is Sole Proprietor?:No
Enumeration Date:2011-02-03
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68020859931041C0700X
MIL2470511101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical