Individual
JONATHON W WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
720 W HILL ST, LOUISVILLE, KY 40208-2216
(502) 636-3164
(502) 634-3731
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3891
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100287460
—
KY
Enumeration date
10/02/2007
Last updated
10/29/2020
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