Provider Demographics
NPI:1366111726
Name:WHITE, ERNEST L (MS,LSC,CT)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:L
Last Name:WHITE
Suffix:
Gender:M
Credentials:MS,LSC,CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5969 E LIVINGSTON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-2907
Mailing Address - Country:US
Mailing Address - Phone:614-864-2700
Mailing Address - Fax:614-864-2702
Practice Address - Street 1:5969 E LIVINGSTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-2907
Practice Address - Country:US
Practice Address - Phone:614-864-2700
Practice Address - Fax:614-864-2702
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2103371101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional