Organization
ALICE WOODSON WHITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICE MIRIAM WOODSON WHITE L.C.S.W. (SOLEPROPRIETOR/MENTALHEALTHTHERAPY)
(631) 675-9494
Entity
Organization
Contact information
Practice address
290 MAIN ST, SUITE 5A, SETAUKET, NY 11733-2871
(631) 675-9494
Mailing address
PO BOX 2381, SETAUKET, NY 11733-0741
(631) 675-9494
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0720745441
NY
251S00000X
Community/Behavioral Health Agency
Primary
73 081011
NY
Other
Enumeration date
02/20/2012
Last updated
08/07/2013
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