Provider Demographics
NPI:1023768793
Name:WHITE, ANDREW JEFFREY (LCSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JEFFREY
Last Name:WHITE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 NW 56TH ST STE 150A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4548
Mailing Address - Country:US
Mailing Address - Phone:405-717-9840
Mailing Address - Fax:405-951-2273
Practice Address - Street 1:3525 NW 56TH ST STE 150A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4548
Practice Address - Country:US
Practice Address - Phone:405-717-9840
Practice Address - Fax:405-951-2273
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK217801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty