Individual provider Active NPI

Kenneth H White, MSW

  • Addiction (Substance Use Disorder) Counselor
  • Milwaukee, WI
National Provider Identifier
1063795110
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
16394-130 Issued in WI
Practice address
1225 W Mitchell St
#223
Milwaukee, WI 53204-3383
Phone
(414) 383-4455
Fax
(414) 433-0171
NPI assigned
Sep 26, 2011
Last updated
Feb 21, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16394-130 WI Primary
Social Worker 104100000X WI

Addresses

Primary practice location

1225 W Mitchell St
#223
Milwaukee, WI 53204-3383

Mailing address

1225 W Mitchell St
#223
Milwaukee, WI 53204-3383
Phone (414) 383-4455

Other identifiers 1

IdentifierTypeStateIssuer
16394-130OtherWIWI LICENSE SAC-IT

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

State licenses

LicenseStateTypeSpecialty
16394-130WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1063795110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W MITCHELL ST",
            "address_2": "#223",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043383",
            "telephone_number": "414-383-4455",
            "fax_number": "414-433-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W MITCHELL ST",
            "address_2": "#223",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043383",
            "telephone_number": "414-383-4455",
            "fax_number": "414-433-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KENNETH",
        "middle_name": "H",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-26",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16394-130",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI LICENSE SAC-IT",
            "identifier": "16394-130",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.