Jonathan David White, LCSW-C

Individual provider Active NPI Clinical Social Worker · College Park, MD

NPI 1093531980 · NPPES record last updated Nov 25, 2024

Key facts

NPI
1093531980
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
13894 (MD)
Practice address
9513 51St Ave
College Park, MD 20740-4512
Phone
(202) 297-3162
NPI assigned
Nov 25, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13894MDMDPsychiatric Pharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13894 MD Yes

Addresses

Primary practice location

9513 51St Ave
College Park, MD 20740-4512

Mailing address

9513 51St Ave
College Park, MD 20740-4512
Phone (202) 297-3162

Other providers in College Park, MD

All providers in College Park, MD · Clinical Social Worker in Maryland

Sources for this page

Verify at the official NPI Registry.