Provider Demographics
NPI:1881484798
Name:WHITE, MICHELE CHARLET (LPC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:CHARLET
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:CHARLOTTE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC - ASSOCIATE
Mailing Address - Street 1:24403 CANYON ROW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-4906
Mailing Address - Country:US
Mailing Address - Phone:210-391-5416
Mailing Address - Fax:
Practice Address - Street 1:4242 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5640
Practice Address - Country:US
Practice Address - Phone:210-981-4593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional