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Individual

KENNETH H WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
1225 W MITCHELL ST, #223, MILWAUKEE, WI 53204-3383
(414) 383-4455
(414) 433-0171
Mailing address
1225 W MITCHELL ST, #223, MILWAUKEE, WI 53204-3383
(414) 383-4455
(414) 433-0171

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16394-130
WI
104100000X
Social Worker
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16394-130
WI LICENSE SAC-IT
WI
Enumeration date
09/26/2011
Last updated
02/21/2013
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