MR. Johnny White, LCSW

NPI #1306149497 in South Holland, Illinois

Provider Information

NPI Number: 1306149497
Entity Type: Individual
Name: MR. Johnny White, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW
Enumeration Date: Dec 10, 2010
Last Updated: Dec 10, 2010

Practice Location

Address: 15663 KIMBARK AVE
City: South Holland
State: Illinois
ZIP Code: 60473-1826
Phone: (630) 747-4498

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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