Provider Demographics
NPI:1053811919
Name:WHITE, KATHERINE (LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 CHESTNUT ST STE 273
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4140
Mailing Address - Country:US
Mailing Address - Phone:267-861-3685
Mailing Address - Fax:
Practice Address - Street 1:525 S 4TH ST STE 471
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1582
Practice Address - Country:US
Practice Address - Phone:267-861-3685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-17
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0187691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical