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WILLIE DEEANJLO0 WHITE LICDC-CS
NPI 1730576091
Substance Abuse Rehabilitation Facility in London, OH

Active since April 23, 2015
1580 STATE ROUTE 56 SW, LONDON, OH 43140(740) 852-2454 Get Directions Write a Review

NPPES record last updated: April 27, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Willie Deeanjlo0 White Licdc-cs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIE DEEANJLO0 WHITE LICDC-CS (NPI 1730576091) is an individual substance abuse rehabilitation facility provider in London, Ohio and active in the NPI registry since April 2015.

NPPES Registry Identity

NPI1730576091
Entity TypeIndividualMale
Primary Taxonomy324500000X
Provider Legal NameWILLIE DEEANJLO0 WHITECredential: LICDC-CS
Location Address1580 STATE ROUTE 56 SWLondon, OH 43140-8623
Mailing Address770 W Broad StColumbus, OH 43222-1419 · (614) 752-1290
Phone(740) 852-2454
Sole ProprietorYes
Enumeration DateApril 23, 2015
Last NPPES UpdateApril 27, 2015
✔ NPI 1730576091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

1580 STATE ROUTE 56 SW, London, OH 43140
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Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BARBARA JEAN WOODS MD
Internal Medicine
1580 STATE ROUTE 56 SW
LONDON, OH 43140
Madison County (740) 852-2454
STATE OF OHIO
Community/Behavioral Health
1580 STATE ROUTE 56 SW, LONDON CORRECTIONAL INSTITUTION
LONDON, OH 43140
Madison County (740) 852-2454
MRS. TRINA MARIE BOTTORFF NP-C
Nurse Practitioner (Family)
1580 STATE ROUTE 56 SW
LONDON, OH 43140
Madison County (740) 852-2454
MS. VERONICA DENISE BELLAMY LICDC 161589
Counselor (Addiction (Substance Use Disorder))
1580 STATE ROUTE 56 SW
LONDON, OH 43140
Madison County (740) 852-2454

Frequently Asked Questions

What is Willie White's NPI number?

The NPI number assigned to this healthcare provider is 1730576091, enumerated as an "individual" on April 23, 2015.

Where is the provider located?

The provider is located at 1580 STATE ROUTE 56 SW LONDON, OH 43140 and the phone number is (740) 852-2454.

What is the provider's specialty?

Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.