Provider Demographics
NPI:1528140241
Name:WHITE, MARIKAY D (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARIKAY
Middle Name:D
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:19731 E PIKES PEAK CT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7401
Mailing Address - Country:US
Mailing Address - Phone:303-841-4005
Mailing Address - Fax:720-851-8379
Practice Address - Street 1:19731 E PIKES PEAK CT
Practice Address - Street 2:SUITE 201
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7401
Practice Address - Country:US
Practice Address - Phone:303-841-4005
Practice Address - Fax:720-851-8379
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9923161041C0700X
KS16931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical