1376845438 NPI number — ANNA-BRITTA WHITE LCSW

Table of content: ANNA-BRITTA WHITE LCSW (NPI 1376845438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376845438 NPI number — ANNA-BRITTA WHITE LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITE
Provider First Name:
ANNA-BRITTA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'SHAUGHNESSY
Provider Other First Name:
ANNA-BRITTA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1376845438
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
710 BIRCHWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TRAVERSE CITY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49686-2016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
72-052-8354
Provider Business Mailing Address Fax Number:
407-606-6893

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5575 S SEMORAN BLVD STE 36
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32822-1782
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-205-2835
Provider Business Practice Location Address Fax Number:
407-606-6893
Provider Enumeration Date:
11/23/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW18253 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: LC21081 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)