Provider Demographics
NPI:1932452216
Name:WHITE, ANN (MS, NCC, LPCMH)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS, NCC, LPCMH
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC, LPCMH
Mailing Address - Street 1:67 PERTH ST
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-4765
Mailing Address - Country:US
Mailing Address - Phone:302-365-4664
Mailing Address - Fax:302-838-3781
Practice Address - Street 1:1608 NEWPORT GAP PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-6208
Practice Address - Country:US
Practice Address - Phone:302-365-4664
Practice Address - Fax:302-838-3781
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1932452216Medicaid
DE002890284OtherHIGHMARK BC/BS