William Roger White, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149004861 Issued in IL

Practice address

712 E Empire St
Bloomington, IL 61701-3252

Phone

(309) 287-9464

Fax

(309) 827-7576

NPI assigned

Nov 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• William R White Counseling & Psychotherapy PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IL
  • NPI 1447559356
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1356521280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 E EMPIRE ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013252",
            "telephone_number": "309-287-9464",
            "fax_number": "309-827-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 E EMPIRE ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013252",
            "telephone_number": "309-287-9464",
            "fax_number": "309-827-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "WILLIAM",
        "middle_name": "ROGER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149004861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Michael Wheeler
• Matthew While, ATC
• Emily White, DPT
• Katelyn Ann White, OTR/L
• Kay B. White, LCSW
• Ashley Kay Whitley, COTA/L
• Myranda Whitman
• Emily Whitted, DPT
• Haley Whittington
• Rachel A Whittle

• Clinical Social Worker in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.