Provider Demographics
NPI:1154738680
Name:WHITE, WILLIAM HENRY (LICSW, LADC I)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HENRY
Last Name:WHITE
Suffix:
Gender:M
Credentials:LICSW, LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SPRINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-2009
Mailing Address - Country:US
Mailing Address - Phone:413-250-7857
Mailing Address - Fax:413-642-3879
Practice Address - Street 1:215 SPRINGDALE RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-2009
Practice Address - Country:US
Practice Address - Phone:413-250-7857
Practice Address - Fax:413-642-3879
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11860101YA0400X, 101YA0400X
MA1269371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)