Provider Demographics
NPI:1457977803
Name:WHITE, LOUISE LIVINGSTON
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:LIVINGSTON
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7621 1/2 NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-5411
Mailing Address - Country:US
Mailing Address - Phone:310-402-9655
Mailing Address - Fax:
Practice Address - Street 1:7621 1/2 NORTON AVE
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5411
Practice Address - Country:US
Practice Address - Phone:310-402-9655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC7923101YP2500X
CO0002171106H00000X
CA132203106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional