White, Jacquelyn Marie

White, Jacquelyn Marie is an individual health care provider with primary practice located at 2311 Fortune Dr Ste 201 , Lexington KY 40509-4118. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. White, Jacquelyn Marie can be contacted via phone (859) 253-1686.

Contact Information

Primary practice address
2311 Fortune Dr Ste 201 Lexington KY 40509-4118
Phone: (859) 253-1686
Fax: (859) 254-2743
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X Oklahoma
Behavioral Health & Social Service Providers / Professional 101YP2500X 0723 Kentucky

Profile Details

NPI number 1699949792
LBN Legal business name White, Jacquelyn Marie
Credentials MA, LPCA
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2008
Last updated Jun 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699949792 NPPES
Kentucky MEDICAID 30615058

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