Provider Demographics
NPI:1366403354
Name:WHITE, NANETTE CHRISTOPHER (LPCS)
Entity type:Individual
Prefix:MS
First Name:NANETTE
Middle Name:CHRISTOPHER
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPCS
Other - Prefix:MS
Other - First Name:NANETTE
Other - Middle Name:
Other - Last Name:CHRISTOPHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCS
Mailing Address - Street 1:806 MOCKINGBIRD ST
Mailing Address - Street 2:
Mailing Address - City:NAVASOTA
Mailing Address - State:TX
Mailing Address - Zip Code:77868-3056
Mailing Address - Country:US
Mailing Address - Phone:210-845-2525
Mailing Address - Fax:979-289-1108
Practice Address - Street 1:806 MOCKINGBIRD ST
Practice Address - Street 2:
Practice Address - City:NAVASOTA
Practice Address - State:TX
Practice Address - Zip Code:77868-3056
Practice Address - Country:US
Practice Address - Phone:979-289-1100
Practice Address - Fax:979-289-1108
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16468101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1437592-02Medicaid
TX1437592-01Medicaid
TX1437592-05Medicaid
TX143759207Medicaid
TX1437592-03Medicaid
TX85279LOtherBCBS PROVIDER ID
TX143759206Medicaid
TX1437592-04Medicaid