Active NPI
Jacqueline White, CIT
- Addiction (Substance Use Disorder) Counselor
- Monroe, LA
National Provider Identifier
1073125696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 4137
- Practice address
- 2321 Highway 80 E
Monroe, LA 71203-9366 - Phone
- (318) 600-3333
- NPI assigned
- Aug 17, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 4137 | LA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 4137 | LA | Primary |
Addresses
Primary practice location
2321 Highway 80 E
Monroe, LA 71203-9366
Mailing address
2321 Highway 80 E
Monroe, LA 71203-9366
Phone (318) 600-3333
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Monroe | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4137 | LA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644883200000",
"number": "1073125696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2321 HIGHWAY 80 E",
"city": "MONROE",
"state": "LA",
"postal_code": "712039366",
"telephone_number": "318-600-3333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2321 HIGHWAY 80 E",
"city": "MONROE",
"state": "LA",
"postal_code": "712039366",
"telephone_number": "318-600-3333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "JACQUELINE",
"credential": "CIT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-17",
"last_updated": "2022-02-15",
"certification_date": "2022-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "LA",
"license": "4137",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "4137",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Monroe",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2321 Highway 80 E",
"city": "Monroe",
"state": "LA",
"country_code": "US",
"postal_code": "712039366",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.