Provider Demographics
NPI:1427115195
Name:WHITE, JEFFREY WHEELER (LMFT-S)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WHEELER
Last Name:WHITE
Suffix:
Gender:M
Credentials:LMFT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 LA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-4225
Mailing Address - Country:US
Mailing Address - Phone:214-406-7376
Mailing Address - Fax:214-224-2696
Practice Address - Street 1:4124 OAK LAWN AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3136
Practice Address - Country:US
Practice Address - Phone:214-224-2693
Practice Address - Fax:214-224-2696
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000043106H00000X
TX201322106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist