Provider Demographics
NPI:1982703518
Name:WHITE, IVEN EUGENE (LCPC)
Entity Type:Individual
Prefix:MR
First Name:IVEN
Middle Name:EUGENE
Last Name:WHITE
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7267 LEVIN DASHIELL RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:MD
Mailing Address - Zip Code:21830-1133
Mailing Address - Country:US
Mailing Address - Phone:410-742-0001
Mailing Address - Fax:
Practice Address - Street 1:102 W MARKET ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4933
Practice Address - Country:US
Practice Address - Phone:410-860-2673
Practice Address - Fax:410-860-0450
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1038101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health