Individual provider Active NPI

Bridgette Nicole White, MS

  • Clinical Social Worker
  • Hollidaysburg, PA
National Provider Identifier
1053894709
Registry record updated Nov 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW025306 Issued in PA
Practice address
1906 N Juniata St
Hollidaysburg, PA 16648-1908
Phone
(814) 695-2984
Fax
(814) 695-2110
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW025306 PA Primary

Addresses

Primary practice location

1906 N Juniata St
Hollidaysburg, PA 16648-1908

Mailing address

121 Bedford St
Hollidaysburg, PA 16648-1713

Other practice location 1

400 Lakemont Park Blvd
Altoona, PA 16602-5967
Phone (814) 946-0261

Other names 1

  • Bridgette Nicole Durbin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
CW025306PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Soar for Life Clinical CurrentSince Oct 29, 2023 Accepting new patients

Locations

1906 N Juniata St
Hollidaysburg, PA 16648
Phone (814) 695-2984

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732838400000",
    "number": "1053894709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BEDFORD ST",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166481713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 N JUNIATA ST",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166481908",
            "telephone_number": "814-695-2984",
            "fax_number": "814-695-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Lakemont Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "PA",
            "postal_code": "166025967",
            "country_code": "US",
            "telephone_number": "814-946-0261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BRIDGETTE",
        "middle_name": "NICOLE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2024-11-29",
        "certification_date": "2024-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW025306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGETTE",
            "last_name": "DURBIN",
            "middle_name": "NICOLE",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hollidaysburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.