Individual
DERRICK WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC-T,CRPA
Contact information
Practice address
3911 RICHMOND AVE, STATEN ISLAND, NY 10312-5110
(718) 948-3232
Mailing address
321 ODER AVE, STATEN ISLAND, NY 10304-3327
(917) 674-9368
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37149
NY
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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