Bertha White, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15403 Issued in MD

Practice address

605 Post Office Rd Ste 301
Waldorf, MD 20602-1913

Phone

(240) 346-0934

NPI assigned

Apr 3, 2014

Last updated

Nov 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Agent of Change, LLC

  • Clinical Social Worker
  • Waldorf, MD
  • NPI 1538515309
  NPD Authorized official

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1235557570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 POST OFFICE RD STE 301",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021913",
            "telephone_number": "240-346-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 POST OFFICE RD STE 301",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021913",
            "telephone_number": "240-346-0934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BERTHA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "15403",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Westcare Home Health Services, LLC
• Shellayne Whalen
• Antonette Michelle Wheeler
• White Plains Primary Care
• White Plains Primary Care
• Brent White Jr., D.D.S
• Cynthia Velerianee White, L.C.P.C.
• Kenneth Wayne White
• Kenyon White
• Lauren Ashley White

• Clinical Social Worker in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Clinical Social Worker in Maryland

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

Verify at the official NPI Registry.