Provider Demographics
NPI:1912313735
Name:WHITE, GEORGE DAVID (LCPC, MS)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:DAVID
Last Name:WHITE
Suffix:
Gender:M
Credentials:LCPC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7363 KINDLER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2203
Mailing Address - Country:US
Mailing Address - Phone:443-803-0877
Mailing Address - Fax:
Practice Address - Street 1:10450 SHAKER DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1143
Practice Address - Country:US
Practice Address - Phone:410-457-3196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
MDLGP4220101YP2500X
MDLC5866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional