Individual
ANISSA WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3316 BEMISS RD, VALDOSTA, GA 31605-7014
(229) 262-7333
(229) 262-7335
Mailing address
3708 KNIGHTS MILL DR, VALDOSTA, GA 31605-6582
(518) 569-5371
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW006873
GA
1041C0700X
Clinical Social Worker
Primary
LCSW-17343
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW006873
GA BOARD OF PROFESSIONAL COUNSELORS, SOCIAL WORKERS AND MARRIAGE & FAMILY THERAP
GA
01
—
LCSW-17343
AZ STATE BOARD OF BEHAVIORAL HEALTH EXAMINERS
AZ
Enumeration date
08/09/2018
Last updated
04/08/2021
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