Individual
MR. CLEOTIS WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.W., L.C.A.C.
Contact information
Practice address
2646 HIGHWAY AVE STE 108, HIGHLAND, IN 46322
(219) 801-1789
(219) 513-9506
Mailing address
2646 HIGHWAY AVE STE 108, HIGHLAND, IN 46322-1662
(219) 801-1789
(219) 513-9506
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
87000827A
IN
101YP2500X
Professional Counselor
CII-1752
IN
Other
Enumeration date
10/05/2012
Last updated
10/24/2019
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