Provider Demographics
NPI:1699084186
Name:WHITE, TRISHA W (LPC & LADC)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:W
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC & LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E. PINE ST.
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-4855
Mailing Address - Country:US
Mailing Address - Phone:918-932-8390
Mailing Address - Fax:
Practice Address - Street 1:205 E PINE ST STE 8
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-4855
Practice Address - Country:US
Practice Address - Phone:918-932-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1253101YA0400X
OK4085101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4085OtherLPC
OK1253OtherLADC