Provider Demographics
NPI:1124363775
Name:WHITE, SHARNITA (LMHC)
Entity type:Individual
Prefix:
First Name:SHARNITA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10922 SCHUETZ RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5704
Mailing Address - Country:US
Mailing Address - Phone:813-557-4701
Mailing Address - Fax:
Practice Address - Street 1:1027 S VANDEVENTER AVE STE 618
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-3800
Practice Address - Country:US
Practice Address - Phone:772-773-0065
Practice Address - Fax:949-655-5979
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2024-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022025329101YM0800X, 101YP2500X
FLMH18285261QM0850X, 261QM0855X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health