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Individual

ROBERTA L WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
(502) 772-8189
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 953-4700
(502) 772-8189

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1415
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100289480
KY
Enumeration date
08/30/2006
Last updated
04/15/2021
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