Provider Demographics
NPI:1194616151
Name:WHITE, ANNE KITTREDGE (LCSWA)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:KITTREDGE
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 HUDSON AVE APT D9
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3373
Mailing Address - Country:US
Mailing Address - Phone:339-793-3417
Mailing Address - Fax:
Practice Address - Street 1:9205 BAILEYWICK RD FL 2
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-1977
Practice Address - Country:US
Practice Address - Phone:919-845-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NCP0223681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health