Provider Demographics
NPI:1255922134
Name:WHITE, DANIELLE (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:DANIE
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, LMFT
Mailing Address - Street 1:100 W DEAN KEETON ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78712-1091
Mailing Address - Country:US
Mailing Address - Phone:618-303-2306
Mailing Address - Fax:
Practice Address - Street 1:100 W DEAN KEETON ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1091
Practice Address - Country:US
Practice Address - Phone:618-303-2306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74633101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional