Provider Demographics
NPI:1760275499
Name:WHITE, KEVIN GARRETT (LMFT)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:GARRETT
Last Name:WHITE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8633 GAFFNEY ST
Mailing Address - Street 2:
Mailing Address - City:FORT MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755-1503
Mailing Address - Country:US
Mailing Address - Phone:443-380-3180
Mailing Address - Fax:
Practice Address - Street 1:8633 GAFFNEY ST
Practice Address - Street 2:
Practice Address - City:FORT MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755-1503
Practice Address - Country:US
Practice Address - Phone:443-380-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205387251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health