Jasmine Tierra Lache White

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24969 Issued in MD

Practice address

10003 Ruffian Way Ste B
Laurel, MD 20723-2088

Phone

(240) 706-0748

NPI assigned

Jun 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Backpack Medical Group, P.C.

  • Clinical Social Worker
  • Elkridge, MD
  • NPI 1851177570
  Medicare reassignment NPD
• For Wellness, LLC

  • Clinical Social Worker
  • Laurel, MD
  • NPI 1053049544
  NPD Authorized official

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1245898014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10003 RUFFIAN WAY STE B",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207232088",
            "telephone_number": "240-706-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10003 RUFFIAN WAY STE B",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207232088",
            "telephone_number": "240-706-0748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 N Howard St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212185909",
            "country_code": "US",
            "telephone_number": "443-438-6742",
            "fax_number": "443-773-5624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JASMINE TIERRA",
        "middle_name": "LACHE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "24969",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "24969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38-3876389",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wheelhouse Homecare Health Services LLC
• William Stanley Whitaker IV
• Barbara Ann White, MSN, APRN, BC
• Brian Earl White, LMSW
• Craig White, M.D.
• Mareka White
• Sean White, CMT
• Tiffany White, LCSW-C, LICSW
• Zena Ashley White, LGPC
• Elliott M. Whitken, PA-C

• Clinical Social Worker in Laurel, MD
• Providers in Laurel, 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 Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.