Active NPI
Jackie White, LPC
- Professional Counselor
- Phenix City, AL
National Provider Identifier
1295125771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3047
- Practice address
- 3170 Martin Luther King Jr Pkwy S
Phenix City, AL 36869-8405 - Phone
- (334) 298-2405
- NPI assigned
- Feb 4, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3047 | AL | Primary |
Addresses
Primary practice location
3170 Martin Luther King Jr Pkwy S
Phenix City, AL 36869-8405
Mailing address
3170 Martin Luther King Jr Pkwy S
Phenix City, AL 36869-8405
Phone (334) 298-2405
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 |
|---|---|---|---|
| 3047 | AL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Alabama Mental Health-Mental Retardation Board Incorpor | Past | Accepting new patients | |
| East Alabama Mental Health-Mental Retardation Board Incorpor | Past | 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.
-
- Community/Behavioral Health Agency
- Opelika, AL
- NPI 1053281014
-
- Community/Behavioral Health Agency
- Opelika, AL
- NPI 1336169606
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423008000000",
"number": "1295125771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3170 MARTIN LUTHER KING JR PKWY S",
"city": "PHENIX CITY",
"state": "AL",
"postal_code": "368698405",
"telephone_number": "334-298-2405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3170 MARTIN LUTHER KING JR PKWY S",
"city": "PHENIX CITY",
"state": "AL",
"postal_code": "368698405",
"telephone_number": "334-298-2405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "JACKIE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-04",
"last_updated": "2015-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "3047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phenix City, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.