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Organization
JESSIE WHITE PSYCHOTHERAPY PLLC
Active
Organization
JESSIE WHITE PSYCHOTHERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA RAE WHITE LCSW (SOLE MEMBER)
(512) 956-4670
Entity
Organization
Contact information
Practice address
4501 S 2ND ST, AUSTIN, TX 78745-1950
(770) 374-9161
Mailing address
4501 S 2ND ST, AUSTIN, TX 78745-1950
(770) 374-9161
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154948495
SOLE PROPRITER
TX
Enumeration date
11/03/2021
Last updated
11/03/2021
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