Provider Demographics
NPI:1649160847
Name:WHITE, STEPHANIE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:ORM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSW, CSW
Mailing Address - Street 1:118 WILLOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-6495
Mailing Address - Country:US
Mailing Address - Phone:502-422-1466
Mailing Address - Fax:
Practice Address - Street 1:1507 SPRING ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-2939
Practice Address - Country:US
Practice Address - Phone:812-901-6881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2595321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical