White, Johnny
White, Johnny is an sole proprietor health care provider with primary practice located at 15663 Kimbark Ave , South Holland IL 60473-1826. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. White, Johnny can be contacted via phone (630) 747-4498.Contact Information
Primary practice address
15663 Kimbark Ave
South Holland IL 60473-1826
Phone: (630) 747-4498
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 14900674 | Illinois |
Profile Details
| NPI number | 1306149497 |
|---|---|
| LBN Legal business name | White, Johnny |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 10th, 2010 |
| Last updated | Dec 10th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306149497 | NPPES |
| Illinois | Other | 14900674 | LICENSED CLINICAL SOCIAL WORKER |
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