Individual
ELIZABETH P WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
721 AMERICAN AVE, SUITE 501, WAUKESHA, WI 53188-5071
(262) 928-4036
(262) 928-5096
Mailing address
721 AMERICAN AVE, SUITE 501, WAUKESHA, WI 53188-5071
(262) 928-4036
(262) 928-5096
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15569-132
WI
1041C0700X
Clinical Social Worker
Primary
7796-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720357387
—
WI
01
—
7796-123
STATE LICENSE
WI
Enumeration date
12/27/2011
Last updated
10/19/2015
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