Provider Demographics
NPI:1336772151
Name:WHITE, ABBY LYNN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ABBY
Middle Name:LYNN
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:ABBY
Other - Middle Name:LYNN
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:14014 ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NY
Mailing Address - Zip Code:14411-9301
Mailing Address - Country:US
Mailing Address - Phone:585-589-7066
Mailing Address - Fax:
Practice Address - Street 1:14014 ROUTE 31
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411-9301
Practice Address - Country:US
Practice Address - Phone:585-589-7066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0890601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical