Derrick White, LPC
Counselor, Professional in Conway, AR. Individual provider (NPI-1).
NPI number1124474556
StatusActive
Last updated in NPPESMay 4, 2023
Details
- NPI
- 1124474556
- Entity type
- Individual (NPI-1)
- Name
- Derrick White
- Credential
- LPC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 4, 2016
- Certification date
- May 4, 2023
- Last updated
- May 4, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | P1905056 | AR | Yes |
Practice location
855 S German Ln Ste 1Conway, AR 72034-6479
Phone 501-358-6606 · Fax 501-491-0039
Mailing address
1820 S Salem Rd Apt 3Conway, AR 72034-8565
Phone 501-908-7448 · Fax 501-204-8612
Other practice locations
1422 Caldwell St Ste I
Conway, AR 72034-5319
Conway, AR 72034-5319
Phone 501-908-7448 · Fax 501-204-8612
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