Provider Demographics
NPI:1144285115
Name:WHITE, FRANK WILLIAM (LCSW)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:WILLIAM
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 1:820 JORDAN ST.
Mailing Address - Street 2:STE. 570
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4512
Mailing Address - Country:US
Mailing Address - Phone:318-221-4455
Mailing Address - Fax:318-221-4459
Practice Address - Street 1:820 JORDAN ST
Practice Address - Street 2:STE. 570
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4518
Practice Address - Country:US
Practice Address - Phone:318-221-4455
Practice Address - Fax:318-221-4459
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA88071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H525CR75Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER