Provider Demographics
NPI:1295895407
Name:WHITE, MURIEL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MURIEL
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MITZI
Other - Middle Name:B
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:22048 SHERMAN WAY
Mailing Address - Street 2:#214
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303
Mailing Address - Country:US
Mailing Address - Phone:818-888-8428
Mailing Address - Fax:818-888-8495
Practice Address - Street 1:22048 SHERMAN WAY
Practice Address - Street 2:#214
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303
Practice Address - Country:US
Practice Address - Phone:818-888-8428
Practice Address - Fax:818-888-8495
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS81741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW087Medicare ID - Type Unspecified