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Individual

SHANICE N WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC-S, NCC

Contact information

Practice address
4038 GLENNOAK DR, BYRAM, MS 39272-9384
(601) 613-6268
Mailing address
4038 GLENNOAK DR, BYRAM, MS 39272-9384
(601) 613-6268

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1877
MS
101Y00000X
Counselor
LPC011614
GA
101YM0800X
Mental Health Counselor
Primary
2737
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003508069
MS
Enumeration date
01/18/2013
Last updated
06/20/2022
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