Provider Demographics
NPI:1013899251
Name:WHITE, KEONNA SHERRI
Entity type:Individual
Prefix:
First Name:KEONNA
Middle Name:SHERRI
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 NEW SHEPHERDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9019
Mailing Address - Country:US
Mailing Address - Phone:502-350-5000
Mailing Address - Fax:
Practice Address - Street 1:132 HUBBARDS CROSSING DR
Practice Address - Street 2:
Practice Address - City:MOUNT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-5578
Practice Address - Country:US
Practice Address - Phone:502-425-9822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service