Individual
MS. ALICE MIRIAM MARJORIE WOODSON WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R, CASAC
Contact information
Practice address
249 MAIN ST STE 2, SETAUKET, NY 11733-2919
(631) 675-9494
(631) 675-9494
Mailing address
PO BOX 2381, SETAUKET, NY 11733-0741
(631) 675-9494
(631) 675-9494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
29000
NY
101YM0800X
Mental Health Counselor
074544-1
NY
101YM0800X
Mental Health Counselor
Primary
73-081011
NY
104100000X
Social Worker
074544-1
NY
1041C0700X
Clinical Social Worker
73-081011
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03042968
—
NY
Enumeration date
02/04/2008
Last updated
06/17/2022
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