Individual provider Active NPI

Jakobbee White, ALC

  • Mental Health Counselor
  • Dothan, AL
National Provider Identifier
1174008502
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C2935A Issued in AL
Practice address
100 Westside Dr
Dothan, AL 36303-1908
Phone
(334) 793-2237
Fax
(334) 712-6256
NPI assigned
Oct 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X C2935A AL Primary

Addresses

Primary practice location

100 Westside Dr
Dothan, AL 36303-1908

Mailing address

100 Westside Dr
Dothan, AL 36303-1908
Phone (334) 793-2237

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
C2935AALMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chrysalis, a Home for Girls, Inc. Past Accepting new patients
Milestones Psychology and Therapy Inc Single Specialty PastSince Feb 20, 2013 Accepting new patients

Organizations & group practices 2

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": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1174008502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WESTSIDE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031908",
            "telephone_number": "334-793-2237",
            "fax_number": "334-712-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WESTSIDE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031908",
            "telephone_number": "334-793-2237",
            "fax_number": "334-712-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JAKOBBEE",
        "credential": "ALC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "C2935A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.