Individual
MS. JUDITH A WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1011 W MAPLE ST, KALAMAZOO, MI 49008
(269) 353-7607
(269) 888-2260
Mailing address
PO BOX 19696, KALAMAZOO, MI 49019-0696
(269) 353-7607
(269) 888-2260
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401005003
MI
101YM0800X
Mental Health Counselor
Primary
6401005003
MI
103T00000X
Psychologist
6301008661
MI
103TC1900X
Counseling Psychologist
6301008661
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0895250
BCBS OF MICHIGAN
MI
01
—
0C91775
BCBS OF MICHIGAN
MI
01
—
127-089
VALUE OPTIONS
MI
01
—
2029602
CIGNA BEHAVIORAL HEALTH
MI
Enumeration date
11/12/2006
Last updated
05/23/2018
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