Provider Demographics
NPI:1053154732
Name:WHITE, ELAINE BELK (LPC)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:BELK
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 BAMBOO DR APT N213
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-5977
Mailing Address - Country:US
Mailing Address - Phone:214-284-8702
Mailing Address - Fax:
Practice Address - Street 1:2300 BAMBOO DR APT N213
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-5977
Practice Address - Country:US
Practice Address - Phone:214-284-8702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional